EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 78

Results Generated From:
Embase <1980 to 2024 Week 25>
Embase Weekly Updates (updates since 2024-06-14)
Embase <1980 to 2024 Week 25>
Embase Weekly Updates (updates since 2024-06-14)

<1>
Accession Number
2032783820
Title
Early-stage health technology assessment of fractional flow reserve
coronary computed tomography versus standard diagnostics in patients with
stable chest pain in The Netherlands.
Source
PLoS ONE. 19(6 June) (no pagination), 2024. Article Number: e0305189. Date
of Publication: June 2024.
Author
Boot I.W.A.; Planken R.N.; den Hartog A.W.; Vrijhoef H.J.M.
Institution
(Boot, Vrijhoef) Panaxea B.V., Den Bosch, Netherlands
(Planken) Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Centers, Location AMC, Amsterdam, Netherlands
(Planken) Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular
Sciences, Amsterdam, Netherlands
(den Hartog) Department of Cardiology, Amsterdam UMC - Location AMC,
University of Amsterdam, Amsterdam, Netherlands
Publisher
Public Library of Science
Abstract
Objectives The aim of this early-stage Health Technology Assessment (HTA)
was to assess the difference in healthcare costs and effects of fractional
flow reserve derived from coronary computed tomography (FFRct) compared to
standard diagnostics in patients with stable chest pain in The
Netherlands. Methods A decision-tree model was developed to assess the
difference in total costs from the hospital perspective, probability of
correct diagnoses, and risk of major adverse cardiovascular events at one
year follow-up. One-way sensitivity analyses were conducted to determine
the main drivers of the cost difference between the strategies. A
threshold analysis on the added price of FFRct analysis (computational
analysis only) was conducted. Results The mean one-year costs were 2,680
per patient for FFRct and 2,915 per patient for standard diagnostics. The
one-year probability of correct diagnoses was 0.78 and 0.61, and the
probability of major adverse cardiovascular events was
1.92x10^-5 and 0.01, respectively. The probability and costs of
revascularization and the specificity of coronary computed tomography
angiography had the greatest effect on the difference in costs between the
strategies. The added price of FFRct analysis should be below 935 per
patient to be considered the least costly option. Conclusions The
early-stage HTA findings suggest that FFRct may reduce total healthcare
spending, probability of incorrect diagnoses, and major adverse
cardiovascular events compared to current diagnostics for patients with
stable chest pain in the Dutch healthcare setting over one year. Future
cost-effectiveness studies should determine a value-based pricing for
FFRct and quantify the economic value of the anticipated therapeutic
impact.<br/>Copyright: &#xa9; 2024 Boot et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<2>
[Use Link to view the full text]
Accession Number
2032722071
Title
A bibliometric analysis of myocardial bridge combined with myocardial
infarction.
Source
Medicine (United States). 103(23) (pp e38420), 2024. Date of Publication:
07 Jun 2024.
Author
Zhang H.; Cao Y.
Institution
(Zhang) School of Graduate, Tianjin University of Traditional Chinese
Medicine, Tianjin, China
(Cao) Department of Cardiology, Tianjin Union Medical Center, Tianjin,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The aim of this study is to analyze the process and frontiers
of research in myocardial bridges (MB) to identify future research
directions in the last 3 decades. <br/>Method(s): Relevant literature on
MB combined with myocardial infarction (MI) was searched from 1991 to 2023
in the Web of Science database, and was analyzed by bibliometric analysis
using VOSviewer, CiteSpace, and the R package "bibliometrix." Results: A
total of 1233 English articles were included in this study. The number of
published articles showed an increasing trend yearly. From 2017 to 2022,
the annual publication volume rose rapidly, and in 2021 the publication
volume even reached 95 articles, which was the highest in all years. These
publications were from 68 countries and 1854 institutions, with the
leading country being the U.S. and the leading institution being Columbia
University. Myoho Clinical International has a close collaborative
relationship with Columbia University, while in recent years, the Harvard
Medical School has explored the study of MB combined with MI. Annals of
Thoracic Surgery was the journal with the highest number of publications,
and Takayama Hiroo and Naka Yoshifumi were the authors with the highest
number of publications. The most common keywords were MI, cardiogenic
shock, and MB. <br/>Conclusion(s): Our findings can help researchers
explore the current status of MB combined with MI research and choose new
survey routes for upcoming studies. Prevalence and prognosis, mechanism of
MB combined with MI and molecular mechanism may become the focus of future
research. In addition, more research and cooperation are needed
worldwide.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<3>
Accession Number
2032706004
Title
Mechanisms of action behind the protective effects of proactive esophageal
cooling during radiofrequency catheter ablation in the left atrium.
Source
Heart Rhythm O2. 5(6) (pp 403-416), 2024. Date of Publication: June 2024.
Author
Omotoye S.; Singleton M.J.; Zagrodzky J.; Clark B.; Sharma D.; Metzl M.D.;
Gallagher M.M.; Meininghaus D.G.; Leung L.; Garg J.; Warrier N.; Panico
A.; Tamirisa K.; Sanchez J.; Mickelsen S.; Sardana M.; Shah D.; Athill C.;
Hayat J.; Silva R.; Clark A.T.; Gray M.; Levi B.; Kulstad E.; Girouard S.;
Zagrodzky W.; Montoya M.M.; Bustamante T.G.; Berjano E.; Gonzalez-Suarez
A.; Daniels J.
Institution
(Omotoye) Cleveland Clinic, Cleveland, Ohio, United States
(Singleton) WellSpan York Hospital, York, Pennsylvania, United States
(Zagrodzky) St. David's Medical Center, Texas Cardiac Arrhythmia
Institute, Austin, Texas, United States
(Clark) Ascension St. Vincent, Indianapolis, IN, United States
(Sharma) NCH Rooney Heart Institute, Naples, Florida, United States
(Metzl) NorthShore University Health System, Evanston, IL, United States
(Gallagher, Leung) St George's University Hospitals NHS Foundation Trust,
London, United Kingdom
(Meininghaus) Carl-Thiem Klinikum gGmbH, Cottbus, Germany
(Garg) Loma Linda University Medical Center, Loma Linda, California,
United States
(Warrier) MemorialCare Heart & Vascular Institute, Fountain Valley, CA,
United States
(Panico) Cardiovascular Associates of Mesa, Mesa, Arizona, United States
(Tamirisa, Sanchez) Cardiac Electrophysiology, Texas Cardiac Arrhythmia
Institute, Dallas, Texas, United States
(Mickelsen) Scripps Health, La Jolla, California, United States
(Sardana) Mayo Clinic, Phoenix, Arizona, United States
(Shah) Ascension Providence Hospital, Detroit, MI, United States
(Athill) Sharp Memorial Hospital, San Diego, California, United States
(Hayat) Department of Gastroenterology, St George's University Hospital,
London, United Kingdom
(Silva) Department of Medicine, Division of Gastroenterology, University
of Illinois at Chicago, Chicago, Illinois, United States
(Silva) Advocate Aurora Christ Medical Center, Chicago, Illinois, United
States
(Clark, Levi, Kulstad, Daniels) University of Texas Southwestern Medical
Center, Dallas, Texas, United States
(Gray) Attune Medical, Chicago, Illinois, United States
(Girouard) Ten15 Ventures, Westlake, Ohio, United States
(Zagrodzky) Colorado College, Colorado Springs, CO, United States
(Montoya, Bustamante) In Silico Science & Engineering S.A.S., Medellin,
Colombia
(Berjano) Department of Electronic Engineering, Universitat Politecnica de
Valencia, Valencia, Spain
(Gonzalez-Suarez) Translational Medical Device Lab, School of Medicine,
University of Galway, Galway, Ireland
(Gonzalez-Suarez) Valencian International University, Valencia, Spain
Publisher
Elsevier B.V.
Abstract
Proactive esophageal cooling for the purpose of reducing the likelihood of
ablation-related esophageal injury resulting from radiofrequency (RF)
cardiac ablation procedures is increasingly being used and has been Food
and Drug Administration cleared as a protective strategy during left
atrial RF ablation for the treatment of atrial fibrillation. In this
review, we examine the evidence supporting the use of proactive esophageal
cooling and the potential mechanisms of action that reduce the likelihood
of atrioesophageal fistula (AEF) formation. Although the pathophysiology
behind AEF formation after thermal injury from RF ablation is not well
studied, a robust literature on fistula formation in other conditions (eg,
Crohn disease, cancer, and trauma) exists and the relationship to AEF
formation is investigated in this review. Likewise, we examine the
abundant data in the surgical literature on burn and thermal injury
progression as well as the acute and chronic mitigating effects of
cooling. We discuss the relationship of these data and maladaptive healing
mechanisms to the well-recognized postablation pathophysiological effects
after RF ablation. Finally, we review additional important considerations
such as patient selection, clinical workflow, and implementation
strategies for proactive esophageal cooling.<br/>Copyright &#xa9; 2024
Heart Rhythm Society

<4>
Accession Number
2030161229
Title
The effect of an improved ICU physical environment on outcomes and
post-ICU recovery-a protocol.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 376. Date of
Publication: December 2024.
Author
Tronstad O.; Zangerl B.; Patterson S.; Flaws D.; Yerkovich S.; Szollosi
I.; White N.; Garcia-Hansen V.; Leonard F.R.; Weger B.D.; Gachon F.; Brain
D.; Lavana J.; Hodgson C.; Fraser J.F.
Institution
(Tronstad, Zangerl, Patterson, Flaws, White, Fraser) Critical Care
Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences
Building, Rode Road, Chermside, Brisbane, Qld 4032, Australia
(Tronstad, Fraser) Faculty of Medicine, University of Queensland,
Brisbane, Australia
(Tronstad) Physiotherapy Department, The Prince Charles Hospital,
Brisbane, Australia
(Patterson) School of Dentistry, University of Queensland, Brisbane,
Australia
(Flaws) Department of Mental Health, Metro North Mental Health, Caboolture
Hospital, Caboolture, Australia
(Flaws) School of Clinical Sciences, Queensland University of Technology,
Brisbane, Australia
(Yerkovich) Menzies School of Health Research and Faculty of Health,
Queensland University of Technology, Brisbane, Australia
(Szollosi) Sleep Disorders Centre, The Prince Charles Hospital, Brisbane,
Australia
(White, Brain) Australian Centre for Health Services Innovation, School of
Public Health and Social Work, Queensland University of Technology,
Brisbane, Australia
(Garcia-Hansen, Leonard) School of Architecture and Built Environment,
Faculty of Engineering, Queensland University of Technology, Brisbane,
Australia
(Weger, Gachon) Institute for Molecular Bioscience, The University of
Queensland, Brisbane, Australia
(Lavana) Adult Intensive Care Services, The Prince Charles Hospital,
Brisbane, QLD, Australia
(Hodgson) Australian and New Zealand Intensive Care Research Centre,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, Australia
(Hodgson) Division of Clinical Trial and Cohort Studies, School of Public
Health and Preventive Medicine, Monash University, Melbourne, Australia
(Hodgson) Physiotherapy Department, Alfred Hospital, Melbourne, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Intensive care medicine continues to improve, with advances in
technology and care provision leading to improved patient survival.
However, this has not been matched by similar advances in ICU bedspace
design. Environmental factors including excessive noise, suboptimal
lighting, and lack of natural lights and views can adversely impact staff
wellbeing and short- and long-term patient outcomes. The personal, social,
and economic costs associated with this are potentially large. The ICU of
the Future project was conceived to address these issues. This is a
mixed-method project, aiming to improve the ICU bedspace environment and
assess impact on patient outcomes. Two innovative and adaptive ICU
bedspaces capable of being individualised to patients' personal and
changing needs were co-designed and implemented. The aim of this study is
to evaluate the effect of an improved ICU bedspace environment on patient
outcomes and operational impact. <br/>Method(s): This is a prospective
multi-component, mixed methods study including a randomised controlled
trial. Over a 2-year study period, the two upgraded bedspaces will serve
as intervention beds, while the remaining 25 bedspaces in the study ICU
function as control beds. Study components encompass (1) an objective
environmental assessment; (2) a qualitative investigation of the ICU
environment and its impact from the perspective of patients, families, and
staff; (3) sleep investigations; (4) circadian rhythm investigations; (5)
delirium measurements; (6) assessment of medium-term patient outcomes; and
(7) a health economic evaluation. <br/>Discussion(s): Despite growing
evidence of the negative impact the ICU environment can have on patient
recovery, this is an area of critical care medicine that is understudied
and commonly not considered when ICUs are being designed. This study will
provide new information on how an improved ICU environment impact holistic
patient recovery and outcomes, potentially influencing ICU design
worldwide. Trial registration: ACTRN12623000541606. Registered on May 22,
2023.
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&is
Review=true.<br/>Copyright &#xa9; The Author(s) 2024.

<5>
Accession Number
2032706462
Title
LANDMARK comparison of early outcomes of newer-generation Myval
transcatheter heart valve series with contemporary valves (Sapien and
Evolut) in real-world individuals with severe symptomatic native aortic
stenosis: a randomised non-inferiority trial.
Source
The Lancet. (no pagination), 2024. Date of Publication: 2024.
Author
Baumbach A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Ijsselmuiden A.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios
V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De Sousa
Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.; Webster M.;
Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Angeras O.; Kim
W.-K.; Rothe J.; Kristic I.; Peral V.; Garg S.; Elzomor H.; Tobe A.;
Morice M.-C.; Onuma Y.; Soliman O.; Serruys P.W.; Siqueira D.; Pinto I.;
Cervone A.; Assef J.; Vilela A.; Paladino A.; Ramos A.; Rezende M.;
Ghorayeb S.; Braga Silva T.R.; Gjorgjievska S.; Hadzibegovic I.; Jurin I.;
Sipic T.; Pavlovic N.; Rudez I.; Manola S.; GALLET DE SAINT-AURIN R.;
BOUKANTAR M.; NICOLAS E.; ENNEZAT P.V.; URIEN J.M.; Vincent F.; Delhaye
C.; Denimal T.; Cosenza A.; Pamart T.; Porouchani S.; Pontana F.;
Montaigne D.; Balmette V.; Bechiri M.; Chen E.; Janah D.; Matthias R.;
Westermann D.; Valina C.; Ferenc M.; Loffelhardt N.; Rahimi F.; Breitbart
P.; Franke K.; Czerny M.; Diab N.; Sick P.; Adeishvili M.; Mangner N.;
Haussig S.; Sveric K.; Crusius L.; Roehlig M.; Koliastasis L.; Drakopoulou
M.; Katsaros O.; Ktenopoulos N.; Ioanniadis A.; Evangelou S.; Ninios I.;
Molnar L.; Papp R.; Arnold-Bela F.; Demeterne Kiss O.; Nagy A.; Czimbalmos
C.; Pellegrinni D.; Montonati C.; Pellicano M.; Guagliumi G.; Tespili M.;
Barbara B.; Filippo R.; Marco A.; Ciro V.; Luca F.; Eustachio A.; Giacomo
I.; Cannone G.; Brambilla N.; Testa L.; Avondo S.; Valvo R.; Clarke R.;
Fish M.; Kosowski M.; Krawczyk M.; Kubler P.; Kotwica T.; Teles R.;
Goncalves P.; Raposo L.; Brito J.; Leal S.; Freitas P.; Ribeiras R.;
Poliacikova P.; Mihaolovic P.M.; Terseglav S.; Steblovnik K.; Cercek M.;
Vitez L.; Sustersic M.; Kovac A.; Kogoj P.; Dimitrovska L.; Arana J.R.D.;
Martinez S.S.; Dieguez A.R.; Barrero A.; Gonzalez-Bartol E.; Aristizabal
C.; Frutos A.S.; Luna J.P.S.; Gomez M.G.; Gabella T.R.; Nelson V.Q.;
Medina J.N.; Ojeda S.; de Lezo J.S.; Romero M.; Gonzalez-Manzanares R.;
Alvarado M.; Mesa D.; Perea J.; Petursson P.; Alchay M.; Andreen S.; Van
Gameren M.; den Heijer P.; Meuwissen M.; CHENG J.M.; Vos J.; Scholzel
B.E.; Simsek C.; Hubbers S.; Stens N.A.; Versteeg G.A.A.; Rooijakkers
M.J.P.; Gehlmann H.R.; Verkroost M.W.A.; Geuzebroek G.S.C.; Van Wely M.H.;
Van Geuns R.J.; van Nunen L.X.; van Garsse L.A.F.M.; Timmers L.; ten Berg
J.; Kraaijeveld A.O.; Dickinson M.G.; Dessing T.C.; Mokhles M.M.
Institution
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(Amat-Santos) Department of Cardiology, University Clinical Hospital of
Valladolid, Valladolid, Spain
(Hudec) Department of Acute Cardiology, Middle-Slovak Institute Of
Cardiovascular Diseases, Banska Bystrica, Slovakia
(Bunc) Department of Cardiology, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Ijsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Laanmets) Department of Invasive Cardiology, North Estonia Medical
Centre, Tallinn, Estonia
(Unic) Department of Cardiac and Transplant Surgery, University Hospital
Dubrava, Zagreb, Croatia
(Merkely) Heart and Vascular Centre, Semmelweis University Heart and
Vascular Centre, Budapest, Hungary
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Ninios) Department of Cardiology, European Interbalkan Medical Center,
Thessaloniki, Greece
(Protasiewicz) Department of Cardiology, Institute of Heart Diseases,
Wroclaw Medical University, Wroclaw, Poland
(Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Martin) Department of Interventional Cardiology, University Hospital of
Gran Canaria Dr Negrin, Las Palmas, Spain
(Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao
Paulo, Brazil
(De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon,
Lisbon, Portugal
(van Belle) Department of Interventional Cardiology, Lille University,
Lille, France
(Linke) Department of Internal Medicine and Cardiology, University Clinic,
Heart Center Dresden, University of Technology Dresden, Dresden, Germany
(Ielasi) Department of Interventional Cardiology, IRCCS Galeazzi
Sant'Ambrogio Hospital, Milan, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Webster) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Toutouzas) Department of Cardiology, Hippokration Hospital, Athens,
Greece
(Teiger) Department of Medico-surgical Cardiovascular and Anaesthesiology,
Henri-Mondor University Hospital, Creteil, France
(Bedogni) Department of Clinical Cardiology, San Donato Hospital, Milan,
Italy
(Voskuil) Department of Interventional Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Pan) Department of Cardiology, University Hospital Reina Sofia,
University of Cordoba, Cordoba, Spain
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angeras) Department of Clinical and Molecular Medicine, Gothenburg
University, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giessen, Germany
(Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
(Rothe) Department of Cardiology and Angiology, University Heart Center
Freiburg Bad Krozingen, University Medical Center Freiburg, Freiburg,
Germany
(Rothe) Department of Cardiology and Angiology, Faculty of Medicine,
University of Freiburg, Freiburg, Germany
(Kristic) Department of Cardiology, University Hospital of Split, Split,
Croatia
(Peral) Department of Cardiology, Son Espases University Hospital, Palma,
Spain
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Elzomor, Tobe, Onuma, Soliman, Serruys) Department of Cardiology, School
of Medicine, University of Galway, Galway, Ireland
(Morice) Cardiovascular European Research Center, Paris, France
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation is an established,
guideline-endorsed treatment for severe aortic stenosis. Precise sizing of
the balloon-expandable Myval transcatheter heart valve (THV) series with
the aortic annulus is facilitated by increasing its diameter in 1.5 mm
increments, compared with the usual 3 mm increments in valve size. The
LANDMARK trial aimed to show non-inferiority of the Myval THV series
compared with the contemporary THVs Sapien Series (Edwards Lifesciences,
Irvine, CA, USA) or Evolut Series (Medtronic, Minneapolis, MN, USA).
<br/>Method(s): In this prospective, multinational, randomised,
open-label, non-inferiority trial across 31 hospitals in 16 countries
(Germany, France, Sweden, the Netherlands, Italy, Spain, New Zealand,
Portugal, Greece, Hungary, Poland, Slovakia, Slovenia, Croatia, Estonia,
and Brazil), 768 participants with severe symptomatic native aortic
stenosis were randomly assigned (1:1) to the Myval THV or a contemporary
THV. Eligibility was primarily decided by the heart team in accordance
with 2021 European Society of Cardiology guidelines. As per the criteria
of the third Valve Academic Research Consortium, the primary endpoint at
30 days was a composite of all-cause mortality, all stroke, bleeding
(types 3 and 4), acute kidney injury (stages 2-4), major vascular
complications, moderate or severe prosthetic valve regurgitation, and
conduction system disturbances resulting in a permanent pacemaker
implantation. Non-inferiority of the study device was tested in the
intention-to-treat population using a non-inferiority margin of 10.44% and
assuming an event rate of 26.10%. This trial is registered with
ClinicalTrials.gov, NCT04275726, and EudraCT, 2020-000137-40, and is
closed to new participants. <br/>Finding(s): Between Jan 6, 2021, and Dec
5, 2023, 768 participants with severe symptomatic native aortic stenosis
were randomly assigned, 384 to the Myval THV and 384 to a contemporary
THV. 369 (48%) participants had their sex recorded as female, and 399
(52%) as male. The mean age of participants was 80.0 years (SD 5.7) for
those treated with the Myval THV and 80.4 years (5.4) for those treated
with a contemporary THV. Median Society of Thoracic Surgeons scores were
the same in both groups (Myval 2.6% [IQR 1.7-4.0] vs contemporary 2.6%
[1.7-4.0]). The primary endpoint showed non-inferiority of the Myval (25%)
compared with contemporary THV (27%), with a risk difference of -2.3%
(one-sided upper 95% CI 3.8, p<inf>non-inferiority</inf><0.0001). No
significant difference was seen in individual components of the primary
composite endpoint. <br/>Interpretation(s): In individuals with severe
symptomatic native aortic stenosis, the Myval THV met its primary endpoint
at 30 days. <br/>Funding(s): Meril Life Sciences.<br/>Copyright &#xa9;
2024 Elsevier Ltd

<6>
Accession Number
2029886885
Title
Efficacy of Epsilon Aminocaproic Acid Versus Placebo in Coronary Artery
Bypass Graft: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Current Treatment Options in Cardiovascular Medicine. 26(7) (pp 161-174),
2024. Date of Publication: July 2024.
Author
Rabiee Rad M.; Ghasempour Dabaghi G.; Amani-Beni R.
Institution
(Rabiee Rad, Ghasempour Dabaghi) Interventional Cardiology Research
Center, Cardiovascular Research Institute, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Amani-Beni) School of Medicine, Isfahan University of Medical Science,
Isfahan, Iran, Islamic Republic of
Publisher
Springer
Abstract
Introduction: The aim of this study was to investigate the efficacy of
epsilon aminocaproic acid (EACA) as a prophylactic antifibrinolytic agent
in patients undergoing coronary artery bypass graft (CABG) surgery.
<br/>Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) comparing the efficacy of EACA in CABG surgery
with placebo groups was performed. The outcomes assessed included
postoperative 24-h and total blood loss, pre- and postoperative hemoglobin
change, and blood transfusion requirements. <br/>Result(s): A total of 16
RCTs with 897 participants were included in the meta-analysis. The
analysis revealed that EACA significantly reduced 24-h postoperative blood
loss compared to placebo (WMD = -135 ml, 95% CI: -217, -53 ml,
I² = 65.3%). However, there was no significant difference in
total blood loss between the EACA and placebo groups. EACA administration
also reduced the transfusion rate for platelets (WMD = -0.09, 95% CI:
-0.1, -0.02, I² = 65.3%), but not for red blood cells, fresh
frozen plasma, or cryoprecipitate. There was no significant difference in
hemoglobin decline between EACA and placebo groups. <br/>Conclusion(s):
This meta-analysis suggests the use of EACA as a prophylactic
antifibrinolytic agent in CABG surgery. It effectively reduces
postoperative 24-h 24-h blood loss compared with placebo after coronary
artery bypass graft (CABG) and potentially minimizing the need for
platelet transfusions. There were no significant differences between EACA
and placebo in terms of total blood loss, hemoglobin decline, and the need
for red blood cells, fresh frozen plasma, or cryoprecipitate. Further
research is needed to evaluate optimal dosage regimens and long-term
outcomes of EACA administration.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<7>
Accession Number
644514281
Title
AI AND RESPIRATORY CARE.
Source
Canadian Journal of Respiratory Therapy. Conference: Canadian Society of
Respiratory Therapists Annual Conference, CSRT 2024. Banff, AB Canada. 60
(pp 7), 2024. Date of Publication: 2024.
Author
Brown J.
Publisher
Canadian Society of Respiratory Therapists
Abstract
Background: The integration of Artificial Intelligence (AI) into
healthcare has heralded a new era of innovation, offering both
opportunities and challenges in decision-making and patient care. This
review delves into the landscape of AI within respiratory care, exploring
its benefits and limitations. <br/>Method(s): Employing a comprehensive
literature review of peer-reviewed articles and case studies, this
presentation investigates current and prospective applications of AI in
respiratory care. Highlighted within are the capabilities of AI in swiftly
analyzing vast datasets, particularly in aiding the diagnosis of chronic
obstructive pulmonary disease (COPD), asthma, acute respiratory distress
syndrome (ARDS), and its integration into the patient care trajectory,
notably in thoracic surgery. <br/>Result(s): Despite its prowess in data
analysis, AI has yet to replicate the intricate skills and nuanced
judgment exhibited by RRTs during hands-on patient interactions. While AI
complements the expertise of respiratory professionals and will encourage
more efficiency, the indispensability of human-centric care in respiratory
therapy remains paramount. <br/>Conclusion(s): The relationship between AI
and respiratory professionals is synergistic, highlighting the potential
for AI to enhance diagnostic accuracy, optimize therapeutic interventions,
and streamline clinical workflows in respiratory care. While AI
undoubtedly aids in the decision-making process, it is equally important
for respiratory professionals to rely on their experience, expertise, and
judgment. This symbiotic partnership thrives when respiratory
professionals continue to ask critical questions, challenge assumptions,
and integrate AI as a supportive tool rather than a replacement for human
decision-making.

<8>
Accession Number
644516388
Title
Percutaneous Left Atrial Appendage Closure Device For Patients With Atrial
Fibrillation In New York.
Source
Stroke. Conference: American Stroke Association's 2023 International
Stroke Conference; State-of-the-Science Stroke Nursing Symposium 2023; and
HEADS-UP: Health Equity and Actionable Disparities in Stroke:
Understanding and Problem-solving Pre-Conference Symposium 2023. Dallas,
TX United States. 54(Supplement 1) (no pagination), 2023. Date of
Publication: February 2023.
Author
Shu L.; Xiao H.; Yaghi S.
Publisher
Wolters Kluwer Health
Abstract
Introduction: Trials have shown that WATCHMAN left atrial appendage
closure (LAAC) for stroke is noninferior to oral anticoagulation (OAC) for
stroke prevention in patients with atrial fibrillation (AF). Since the
approval of WATCHMAN, real world clinical outcome of LAAC is still
limited. We performed a state wide analysis to evaluate clinical outcomes
for AF patients undergo LAAC. <br/>Method(s): Using the Healthcare Cost
and Utilization Project (HCUP) State Inpatient Database, we included New
York state adult patients, who had AF diagnosis with and without LAAC
procedure from 2011 to 2017. Patients who had acute ischemic stroke (AIS)
or history of AIS prior or during index admission were excluded. AF, AIS
and other diagnosis were identified based on standard ICD-9 CM and ICD-10
CM codes. We compared rates of AIS, intracranial hemorrhage (ICH) and
death between patients with and without LAAC. We also constructed a Cox
regression model to determine hazard ratios (HR) of LAAC associated with
each outcome. <br/>Result(s): Of the 627,972 patients with AF admitted,
the mean age was 75.8 and 33.1% were female, and 773 (0.1%) underwent
LAAC. AIS readmission occurred in 0.030% of AF patients without LAAC while
it occurred in 0.012% of patients underwent LAAC. In the Cox regression
model, LAAC had similar AIS readmission (HR 0.84, 95% CI 0.44-1.62, P =
0.602) and ICH readmission (HR 1.688, 95% CI 0.63-4.50, P = 0.296), but
LAAC was associated with less death (HR 0.295, 95% CI 0.20-0.43, P <
0.001). These outcomes remained the same despite adjustment with common
risk factors and insurance type, or adjustment with CHADS VASC scores. In
sensitivity analysis, after restricting to patients that had ICH prior to
index admission, LAAC again had similar AIS readmission (HR 1.884, 95% CI
0.26-13.46, P = 0.528) compared to non-LAAC group but still marginally
associated with less death (HR 0.289, 95% CI 0.07-1.16, P = 0.080).
<br/>Conclusion(s): In New York state, AF patients underwent LAAC
procedural are less likely to have death during follow up despite
adjustment of common risk factors or CHADS VASC score, while AIS and ICH
readmission appears to be similar. However, given potential underlying
confounding by treatment indication, these findings need confirmation by
ongoing randomized control trials.

<9>
Accession Number
644514172
Title
SAFETY OF IMMEDIATE EXTUBATION, AND FACTORS ASSOCIATED WITH DELAYED
EXTUBATION, IN CARDIAC SURGICAL PATIENTS RECEIVING FAST TRACK CARDIAC
ANESTHESIA: AN INTEGRATIVE REVIEW.
Source
Canadian Journal of Respiratory Therapy. Conference: Canadian Society of
Respiratory Therapists Annual Conference, CSRT 2023. Charlottetown, PE
Canada. 59 (pp 135), 2023. Date of Publication: 2023.
Author
Tiganila R.; Raco J.; McCoy C.; Gilbert R.
Publisher
Canadian Society of Respiratory Therapists
Abstract
Background: Early Extubation (EE), within 8 h of cardiac surgery, is
associated with improved resource utilization. Studies demonstrate that
for patients receiving fast track low-dose opioid cardiac anesthesia
(FTCA) protocols EE is as safe as conventional care. Defining the earliest
time points for safe extubation may be further beneficial. This review
seeks to determine if immediate extubation (IE, in the operating room), is
as safe as EE. For some individuals receiving FTCA protocols extubation is
delayed. Understanding factors associated with delayed extubation is
important to perioperative planning and resource management. This review
seeks to identify factors associated with delayed extubation.
<br/>Method(s): MEDLINE, Cochrane Library, EMBASE and CINAHL (to March
2022) were searched. Studies pertaining to FTCA and IE, EE, or factors
associated with delayed extubation were included. All authors extracted,
appraised, and synthesized data. The main outcome measures were treatment
outcomes and factors associated with delayed extubation. <br/>Result(s):
Six studies investigated treatment outcomes associated with FTCA and IE.
One RCT reported that outcomes associated with IE were comparable to those
of EE. Five observational studies reported incidence for 16 treatment
outcomes associated with IE but did not make comparisons to conventional
care. Six observational studies assessed pre-and intraoperative factors
associated with delayed extubation in FTCA patients. Thirty-seven factors
were investigated and 22 were identified in at least one study. The most
frequently reported factors were pre-existing cardiac insufficiency or
renal disease, time on pump and cross-clamp time. Obesity and stroke were
investigated but were not associated with delayed extubation. No study
examined the influence of race, ethnicity or sex on outcomes. Discussion
and <br/>Conclusion(s): Evidence pertaining to treatment outcomes
associated with FTCA and IE is weak. Observational studies cannot
determine causation. Large multicentre randomized control trials are
needed to determine the safety of IE. Although numerous factors have been
associated with delayed extubation, several studies do not describe how or
which factors were selected for examination. Therefore, certain factors
may have yet to be evaluated. Future studies should improve transparency.

<10>
Accession Number
644516912
Title
Left Atrial Appendage Closure In Atrial Fibrillation Patients At High
Intracranial Hemorrhage Risk.
Source
Stroke. Conference: American Stroke Association's 2023 International
Stroke Conference; State-of-the-Science Stroke Nursing Symposium 2023; and
HEADS-UP: Health Equity and Actionable Disparities in Stroke:
Understanding and Problem-solving Pre-Conference Symposium 2023. Dallas,
TX United States. 54(Supplement 1) (no pagination), 2023. Date of
Publication: February 2023.
Author
Fouks A.A.; Das A.S.; Daoud N.; Gokcal E.; Rotschild O.; Greenberg S.M.;
Gurol E.M.
Publisher
Wolters Kluwer Health
Abstract
Background: Lifelong oral anticoagulant (OAC) use is associated with
higher intracranial hemorrhage (ICH) risk in nonvalvular atrial
fibrillation (NVAF) patients. We aimed to assess the long-term outcomes of
left atrial appendage closure (LAAC) in NVAF patients at high baseline ICH
risk, as LAAC was FDAapproved for NVAF patients who have a reasonable
rationale to seek a nonpharmacological alternative to lifelong OAC use.
<br/>Method(s): We collected baseline and follow up data from consecutive
NVAF patients who had LAAC because of either past ICH or finding cerebral
microbleeds (CMB) on MRI without ICH (CMB-only). The outcome measures were
the occurrence of ICH or acute ischemic stroke (AIS) after LAAC.
<br/>Result(s): Out of a total of 644 LAAC performed in a single hospital
system between 2015-2022, 142 NVAF patients had LAAC with WATCHMAN because
of past ICH or CMB-only. Their mean age was 75.8+/- 7.6, 41 were female
(29%). Mean CHA<inf>2</inf> DS<inf>2</inf>-VASc score was 5.24+/-1.4. Of
the 142 patients, 67 (47.2%) had intraparenchymal hemorrhage (IPH, 52%
related to cerebral amyloid angiopathy [CAA]), 19 (13.4%) had
non-traumatic subdural hemorrhage (SDH), 36 (25.3%) had traumatic ICH
(T-ICH), and 20 (14.08%) were CMB-only (65% with CAA pattern). Eighty-one
patients were discharged on OAC (57%) and 133 patients were not taking OAC
at 1 year (94%). Over a mean 1.98 years follow up, one patient had
recurrent non-traumatic IPH (incidence rate [IR] 0.36 per 100
patient-years), four had traumatic ICH/SDH due to severe falls (IR
1.4%/year), and five had AIS (IR 1.78%/year). <br/>Conclusion(s): In NVAF
patients at high ICH risk, our results show a 74% decrease in AIS risk
(actual 1.76%/year vs expected 6.8%/year based on CHA<inf>2</inf>
DS<inf>2</inf>-VASc). Despite the very high ICH risk population studied
including at least 48 CAA patients, only one patient had a recurrent IPH
after LAAC. LAAC should be considered in NVAF patients at high ICH risk
and studied in RCTs in this cohort.

<11>
Accession Number
644515916
Title
Post-procedural New Onset Atrial Fibrillation in Patients Undergoing
Transcatheter Aoritc Valve Implantation versus Surgical Aortic Valve
Replacement for Severe Aortic Stenosis: A Meta-analysis.
Source
Circulation: Cardiovascular Quality and Outcomes. Conference: American
Heart Association's Quality of Care and Outcomes Research 2015 Scientific
Sessions. Baltimore, MD United States. 8(Supplement 2) (no pagination),
2015. Date of Publication: May 2015.
Author
Bhatheja S.; Panchal H.; Rahman Z.; Barry N.; Paul T.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is performed in
patients with severe aortic stenosis who are not a candidate for surgical
aortic valve replacement (SAVR). New onset post-operative atrial
fibrillation is a common complication after SAVR and has also been
reported after TAVI in clinical trials and registries. The objective of
this meta-analysis is to compare incidence of post-procedural new onset
atrial fibrillation in patients who underwent TAVI versus SAVR.
<br/>Method(s): PubMed and the Cochrane Center Register of Controlled
Trials were searched through January 2015. Six studies (n= 1173) which
reported incidence of post-procedural new onset atrial fibrillation
comparing TAVI (n=596) and SAVR (n=577) were included. End point was
post-procedural new onset atrial fibrillation. The odds ratio (OR) with
95% confidence interval (CI) was computed and p<0.05 was considered as a
level of significance. <br/>Result(s): The studies were homogeneous.
Incidence of post-procedural new onset atrial fibrillation was
significantly higher in SAVR group compared to TAVI group (OR: 3.10, CI:
2.20-4.35, p<0.00001) (Figure 1). <br/>Conclusion(s): The results of this
meta-analysis of 1173 patients suggest that SAVR is associated with higher
incidence of post-procedural new onset atrial fibrillation compared to
TAVI procedure. This complication may lead to significant morbidity due to
need of long term anticoagulation as well as possibility of tachycardia
induced cardiomyopathy; however, randomized controlled studies are needed
to further evaluate the long-term clinical outcomes.

<12>
Accession Number
2032867401
Title
An update on the mechanisms and risk factors for anesthesia-related
cardiac arrest in children: a narrative review.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(5) (no
pagination), 2024. Article Number: 844519. Date of Publication: 01 Sep
2024.
Author
Braz L.G.; Braz J.R.C.; Tiradentes T.A.A.; Porto D.D.S.M.; Beserra C.M.;
Vane L.A.; Nascimento Junior P.D.; Modolo N.S.P.; Braz M.G.
Institution
(Braz, Braz, Tiradentes, Porto, Beserra, Vane, Nascimento Junior, Modolo,
Braz) Universidade Estadual Paulista (UNESP), Faculdade de Medicina de
Botucatu, Departamento de Especialidades Cirurgicas e Anestesiologia,
Comissao de Estudos de Parada Cardiaca e Mortalidade em Anestesia, SP,
Botucatu, Brazil
Publisher
Elsevier Editora Ltda
Abstract
The relation between surgery and anesthesia safety in children and a
country's Human Development Index (HDI) value has been described
previously. The aim of this narrative review was to provide an update on
the mechanisms and risk factors of Anesthesia-Related Cardiac Arrest
(ARCA) in pediatric surgical patients in countries with different HDI
values and over time (pre-2001 vs. 2001-2024). Electronic databases were
searched up to March 2024 for studies reporting ARCA events in children.
HDI values range from 0 to 1 (very-high-HDI countries: >= 0.800, high-HDI
countries: 0.700-0.799, medium-HDI countries: 0.550-0.699, and low-HDI
countries: < 0.550). Independent of time, the proportion of children who
suffered perioperative Cardiac Arrest (CA) attributed to
anesthesia-related causes was higher in very-high-HDI countries (50%) than
in countries with HDI values less than 0.8 (15-36%), but ARCA rates were
higher in countries with HDI values less than 0.8 than in very-high-HDI
countries. Regardless of the HDI value, medication-related factors were
the most common mechanism causing ARCA before 2001, while
cardiovascular-related factors, mainly hypovolemia, and
respiratory-related factors, including difficulty maintaining patent
airways and adequate ventilation, were the major mechanisms in the present
century. Independent of HDI value and time, a higher number of ARCA events
occurred in children with heart disease and/or a history of cardiac
surgery, those aged younger than one year, those with ASA physical status
III-V, and those who underwent emergency surgery. Many ARCA events were
determined to be preventable. The implementation of specialized pediatric
anesthesiology and training programs is crucial for anesthesia safety in
children.<br/>Copyright &#xa9; 2024

<13>
Accession Number
2030246571
Title
Hemostatic effects of tranexamic acid in cardiac surgical patients with
antiplatelet therapy: a systematic review and meta-analysis.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 58.
Date of Publication: December 2024.
Author
Tian L.; Li X.; He L.; Ji H.; Yao Y.
Institution
(Tian, Ji, Yao) Department of Anesthesiology, National Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing 100037, China
(Li, He) Department of Anesthesiology, Yunnan Fuwai Cardiovascular
Hospital, Kunming 650102, China
Publisher
BioMed Central Ltd
Abstract
Background: The purpose of the current study was to assess the efficacy of
tranexamic acid (TXA) on reducing bleeding in cardiac surgical patients
with preoperative antiplatelet therapy (APT). <br/>Method(s): Five
electronic databases were searched systematically for
randomized-controlled trials (RCTs) assessing the impact of intravenous
TXA on post-operative bleeding on cardiac surgical patients with
preoperative APT until May 2024. Primary outcome of interest was
post-operative blood loss. Secondary outcomes of interest included the
incidence of reoperation due to post-operative bleeding, post-operative
transfusion requirements of red blood cells (RBC), fresh-frozen plasma
(FFP), and platelet concentrates. Mean difference (MD) with 95% confidence
interval (CI) or odds ratios (OR) with 95% CI was employed to analyze the
data. Subgroup and meta-regression analyses were performed to assess the
possible influence of TXA administration on reducing bleeding and
transfusion requirements. <br/>Result(s): A total of 12 RCTs with 3018
adult cardiac surgical patients (TXA group, 1510 patients; Control group,
1508 patients) were included. The current study demonstrated that TXA
significantly reduced post-operative blood loss (MD = - 0.38 L, 95% CI: -
0.73 to - 0.03, P = 0.03; MD = - 0.26 L, 95% CI: - 0.28 to - 0.24, P <
0.00001; MD = - 0.37 L, 95% CI: - 0.63 to - 0.10, P = 0.007) in patients
receiving dual antiplatelet therapy (DAPT), aspirin, or clopidogrel,
respectively. Patients in TXA group had significantly lower incidence of
reoperation for bleeding as compared to those in Control group. The
post-operative transfusion of RBC and FFP requirements was significantly
lower in TXA group than Control group. Subgroup analyses showed that
studies with DAPT discontinued on the day of surgery significantly
increased the risk of post-operative blood loss [(MD: - 1.23 L; 95% CI: -
1.42 to - 1.04) vs. (MD: - 0.16 L; 95% CI: - 0.27 to - 0.05); P < 0.00001
for subgroup difference] and RBC transfusion [(MD: - 3.90 units; 95% CI: -
4.75 to - 3.05) vs. (MD: - 1.03 units; 95% CI: - 1.96 to - 0.10); P <
0.00001 for subgroup difference] than those with DAPT discontinued less
than 5-7 days preoperatively. <br/>Conclusion(s): This meta-analysis
demonstrated that TXA significantly reduced post-operative blood loss and
transfusion requirements for cardiac surgical patients with preoperative
APT. These potential clinical benefits may be greater in patients with
aspirin and clopidogrel continued closer to the day of surgery. Trial
registration number: CRD42022309427.<br/>Copyright &#xa9; The Author(s)
2024.

<14>
Accession Number
2030221619
Title
Delayed cold-stored vs. room temperature stored platelet transfusions in
bleeding adult cardiac surgery patients-a randomized multicentre pilot
study (PLTS-1).
Source
Pilot and Feasibility Studies. 10(1) (no pagination), 2024. Article
Number: 90. Date of Publication: December 2024.
Author
Bartoszko J.; Peer M.; Grewal D.; Ansari S.; Callum J.; Karkouti K.
Institution
(Bartoszko, Peer, Grewal, Ansari, Karkouti) Department of Anesthesia and
Pain Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Grewal, Ansari, Karkouti) Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Callum) University of Toronto Quality in Utilization, Education and
Safety in Transfusion Research Program, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care, Department of
Medicine, University of Toronto, Toronto, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Platelets stored at 1-6 degreeC are hypothesized to be more
hemostatically active than standard room temperature platelets (RTP)
stored at 20-24 degreeC. Recent studies suggest converting RTP to
cold-stored platelets (Delayed Cold-Stored Platelets, DCSP) may be an
important way of extending platelet lifespan and increasing platelet
supply while also activating and priming platelets for the treatment of
acute bleeding. However, there is little clinical trial data supporting
the efficacy and safety of DCSP compared to standard RTP. <br/>Method(s):
This protocol details the design of a multicentre, two-arm,
parallel-group, randomized, active-control, blinded, internal pilot trial
to be conducted at two cardiac surgery centers in Canada. The study will
randomize 50 adult (>= 18 years old) patients undergoing at least
moderately complex cardiac surgery with cardiopulmonary bypass and
requiring platelet transfusion to receive either RTP as per standard of
care (control group) or DCSP (intervention group). Patients randomized to
the intervention group will receive ABO-identical, buffy-coat,
pathogen-reduced, platelets in platelet additive solution maintained at 22
degreeC for up to 4 days then placed at 4 degreeC for a minimum of 24 h,
with expiration at 14 days after collection. The duration of the
intervention is from the termination of cardiopulmonary bypass to 24 h
after, with a maximum of two doses of DCSP. Thereafter, all patients will
receive RTP. The aim of this pilot is to assess the feasibility of a
future RCT comparing the hemostatic effectiveness of DCSP to RTP (defined
as the total number of allogeneic blood products transfused within 24 h
after CPB) as well as safety. Specifically, the feasibility objectives of
this pilot study are to determine (1) recruitment of >= 15% eligible
patients per center per month); (2) appropriate platelet product available
for >= 90% of patients randomized to the cold-stored platelet group; (3)
Adherence to randomization assignment (> 90% of patients administered
assigned product). <br/>Discussion(s): DCSP represents a promising
logistical solution to address platelet supply shortages and a potentially
more efficacious option for the management of active bleeding. No
prospective clinical studies on this topic have been conducted. This
proposed internal pilot study will assess the feasibility of a larger
definitive study. Trial registration: NCT 06147531
(clinicaltrials.gov).<br/>Copyright &#xa9; The Author(s) 2024.

<15>
Accession Number
2030204230
Title
Harnessing the power of artificial intelligence in predicting all-cause
mortality in transcatheter aortic valve replacement: a systematic review
and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1343210. Date of Publication: 2024.
Author
Sazzad F.; Ler A.A.L.; Furqan M.S.; Tan L.K.Z.; Leo H.L.; Kuntjoro I.; Tay
E.; Kofidis T.
Institution
(Sazzad, Ler, Tan, Kofidis) Department of Surgery, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore, Singapore
(Furqan) Department of Biomedical Informatics, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore, Singapore
(Leo) Department of Biomedical Engineering, College of Design and
Engineering, National University of Singapore, Singapore, Singapore
(Kuntjoro, Tay) Department of Cardiology, National University Heart
Centre, Singapore, National University Hospital, Singapore, Singapore
(Tay) Asian Heart & Vascular Centre (AHVC), Mount Elizabeth Medical
Centre, Singapore, Singapore
Publisher
Frontiers Media SA
Abstract
Objectives: In recent years, the use of artificial intelligence (AI)
models to generate individualised risk assessments and predict patient
outcomes post-Transcatheter Aortic Valve Implantation (TAVI) has been a
topic of increasing relevance in literature. This study aims to evaluate
the predictive accuracy of AI algorithms in forecasting post-TAVI
mortality as compared to traditional risk scores. <br/>Method(s):
Following the Preferred Reporting Items for Systematic Reviews and
Meta-analyses for Systematic Reviews (PRISMA) standard, a systematic
review was carried out. We searched four databases in total-PubMed,
Medline, Embase, and Cochrane-from 19 June 2023-24 June, 2023.
<br/>Result(s): From 2,239 identified records, 1,504 duplicates were
removed, 735 manuscripts were screened, and 10 studies were included in
our review. Our pooled analysis of 5 studies and 9,398 patients revealed a
significantly higher mean area under curve (AUC) associated with AI
mortality predictions than traditional score predictions (MD: -0.16, CI:
-0.22 to -0.10, p < 0.00001). Subgroup analyses of 30-day mortality (MD:
-0.08, CI: -0.13 to -0.03, p = 0.001) and 1-year mortality (MD: -0.18, CI:
-0.27 to -0.10, p < 0.0001) also showed significantly higher mean AUC with
AI predictions than traditional score predictions. Pooled mean AUC of all
10 studies and 22,933 patients was 0.79 [0.73, 0.85]. <br/>Conclusion(s):
AI models have a higher predictive accuracy as compared to traditional
risk scores in predicting post-TAVI mortality. Overall, this review
demonstrates the potential of AI in achieving personalised risk assessment
in TAVI patients. Registration and protocol: This systematic review and
meta-analysis was registered under the International Prospective Register
of Systematic Reviews (PROSPERO), under the registration name "All-Cause
Mortality in Transcatheter Aortic Valve Replacement Assessed by Artificial
Intelligence" and registration number CRD42023437705. A review protocol
was not prepared. There were no amendments to the information provided at
registration. Systematic Review Registration: https://www.crd.york.ac.uk/,
PROSPERO (CRD42023437705).<br/>Copyright 2024 Sazzad, Ler, Furqan, Tan,
Leo, Kuntjoro, Tay and Kofidis.

<16>
Accession Number
2030201175
Title
Simultaneous Heart and Kidney Transplantation: A Systematic Review and
Proportional Meta-Analysis of Its Characteristics and Long-Term Variables.
Source
Transplant International. 37 (no pagination), 2024. Article Number: 12750.
Date of Publication: 2024.
Author
Sampaio N.Z.; Faleiro M.D.; Vieira L.V.D.S.; Lech G.E.; Viana S.W.;
Tavares C.P.O.; Mattiazzi A.D.; Burke G.W.
Institution
(Sampaio) University of Araraquara, Araraquara, Brazil
(Faleiro) Federal University of Minas Gerais, Minas Gerais, Belo
Horizonte, Brazil
(Vieira) Federal University of Piaui, Piaui, Teresina, Brazil
(Lech) Pontifical Catholic University of Rio Grande do Sul, Rio Grande do
Sul, Porto Alegre, Brazil
(Viana) Kursk State Medical University, Kursk Oblast, Kursk, Russian
Federation
(Tavares) Salvador University, Bahia, Salvador, Brazil
(Mattiazzi, Burke) Leonard M. Miller School of Medicine, University of
Miami, Miami, FL, United States
Publisher
Frontiers Media SA
Abstract
Patients with end-stage heart disease who undergo a heart transplant
frequently have simultaneous kidney insufficiency, therefore simultaneous
heart and kidney transplantation is an option and it is necessary to
understand its characteristics and long-term variables. The recipient
characteristics and operative and long-term variables were assessed in a
meta-analysis. A total of 781 studies were screened, and 33 were
thoroughly reviewed. 15 retrospective cohort studies and 376 patients were
included. The recipient's mean age was 51.1 years (95% CI 48.52-53.67) and
84% (95% CI 80-87) were male. 71% (95% CI 59-83) of the recipients were
dialysis dependent. The most common indication was ischemic cardiomyopathy
[47% (95% CI 41-53)] and cardiorenal syndrome [22% (95% CI 9-35)]. Also,
33% (95% CI 20-46) of the patients presented with delayed graft function.
During the mean follow-up period of 67.49 months (95% CI 45.64-89.33),
simultaneous rejection episodes of both organ allografts were described in
5 cases only. Overall survival was 95% (95% CI 88-100) at 30 days, 81%
(95% CI 76-86) at 1 year, 79% (95% CI 71-87) at 3, and 71% (95% CI 59-83)
at 5 years. Simultaneous heart and kidney transplantation is an important
option for concurrent cardiac and renal dysfunction and has acceptable
rejection and survival rates.<br/>Copyright &#xa9; 2024 Sampaio, Faleiro,
Vieira, Lech, Viana, Tavares, Mattiazzi and Burke.

<17>
Accession Number
2029775007
Title
Differential Effect of Aortic Valve Replacement for Severe Aortic Stenosis
on Hyperemic and Resting Epicardial Coronary Pressure Indices.
Source
Journal of the American Heart Association. 13(10) (no pagination), 2024.
Article Number: e034401. Date of Publication: 2024.
Author
Minten L.; Bennett J.; Otsuki H.; Takahashi K.; Fearon W.F.; Dubois C.
Institution
(Minten, Bennett, Dubois) Department of Cardiovascular Sciences,
Katholieke Universiteit Leuven, Leuven, Belgium
(Minten, Otsuki, Takahashi, Fearon) Division of Cardiovascular Medicine,
Stanford University, Palo Alto, CA, United States
(Bennett, Dubois) Department of Cardiovascular Medicine, University
Hospitals Leuven (UZ Leuven), Leuven, Belgium
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary pressure indices to assess coronary artery disease
are currently underused in patients with aortic stenosis due to many
potential physiological effects that might hinder their interpretation.
Studies with varying sample sizes have provided us with conflicting
results on the effect of transcatheter aortic valve replacement (TAVR) on
these indices. The aim of this meta-analysis was to study immediate and
long-term effects of TAVR on fractional flow reserve (FFR) and
nonhyperemic pressure ratios (NHPRs). METHODS AND RESULTS: Lesion-specific
coronary pressure data were extracted from 6 studies, resulting in 147
lesions for immediate change in FFR analysis and 105 for NHPR analysis. To
investigate the long-term changes, 93 lesions for FFR analysis and 68 for
NHPR analysis were found. Lesion data were pooled and compared with paired
t tests. Immediately after TAVR, FFR decreased significantly
(-0.0130+/-0.0406 SD, P: 0.0002) while NHPR remained stable
(0.0003+/-0.0675, P: 0.9675). Long-term after TAVR, FFR decreased
significantly (-0.0230+/-0.0747, P: 0.0038) while NHPR increased
nonsignificantly (0.0166+/-0.0699, P: 0.0543). When only borderline NHPR
lesions were considered, this increase became significant
(0.0249+/-0.0441, P: 0.0015). Sensitivity analysis confirmed our results
in borderline lesions. <br/>CONCLUSION(S): TAVR resulted in small
significant, but opposite, changes in FFR and NHPR. Using the standard
cut-offs in patients with severe aortic stenosis, FFR might underestimate
the physiological significance of a coronary lesion while NHPRs might
overestimate its significance. The described changes only play a
clinically relevant role in borderline lesions. Therefore, even in
patients with aortic stenosis, an overtly positive or negative
physiological assessment can be trusted.<br/>Copyright &#xa9; 2024 The
Authors.

<18>
Accession Number
2032856250
Title
The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in
Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Wang W.; Yang W.; Liu A.; Liu J.; Yuan C.
Institution
(Wang, Yuan) Department of Anesthesiology, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Yang) Department of Anesthesiology, Deyang People's Hospital, Sichuan,
Deyang, China
(Liu) Department of Anesthesiology, Heze Municipal Hospital, Shandong,
Heze, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the analgesic effect of erector spinae plane block
in adults undergoing median sternotomy cardiac surgery. Design and
setting: The Cochrane, Embase, and PubMed databases from inception to
January 2024 were searched. The study has been registered in the
International Prospective Register of Systematic Reviews (CRD42023470375).
<br/>Participant(s): Eight randomized controlled trials involving 543
patients, comparing with no block or sham block, were included, whether it
was a single injection or continuous. <br/>Measurements and Main Results:
The primary outcomes were pain scores and opioid consumption. Erector
spinae plane block reduced pain scores immediately after extubation (mean
difference [MD], -1.19; 95% confidence interval [CI], -1.67 to -0.71; p
for heterogeneity = 0.10), at 6 hours after extubation (MD, -1.96; 95% CI,
-2.85 to -1.08; p for heterogeneity < 0.0001), and at 12 hours after
extubation (MD, -0.98; 95% CI, -1.55 to -0.40; p for heterogeneity <
0.00001). The decrease in pain scores reached the minimal clinically
important difference within 6 hours. Opioid consumption 24 hours after
surgery decreased by 35.72 mg of oral morphine equivalents (95% CI, -50.88
to -20.57; p for heterogeneity < 0.0001). Sensitivity analysis confirmed
the stability of results. The quality of primary outcomes was rated as
very low to moderate. <br/>Conclusion(s): Erector spinae plane block
decreased pain scores within 12 hours after extubation, reached the
minimal clinically important difference within 6 hours, and decreased
opioid consumption 24 hours after surgery, based on data of very low to
moderate quality. However, high-quality randomized controlled trials are
necessary to validate these findings.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<19>
Accession Number
2032755396
Title
Clinical decision aids and computed tomography coronary angiography in
patients with suspected acute coronary syndrome.
Source
Emergency Medicine Journal. (no pagination), 2024. Article Number:
213904. Date of Publication: 2024.
Author
Wang K.-L.; Taggart C.; McDermott M.; O'Brien R.; Oatey K.; Keating L.;
Storey R.F.; Felmeden D.; Curzen N.; Kardos A.; Roobottom C.; Smith J.;
Goodacre S.; Newby D.E.; Gray A.J.
Institution
(Wang, Taggart, McDermott, Newby) Centre for Cardiovascular Science,
University of Edinburgh, Edinburgh, United Kingdom
(Wang) School of Medicine, National Yang Ming Chiao Tung University,
Taipei, Taiwan (Republic of China)
(Wang) General Clinical Research Center, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Taggart) Department of Cardiology, Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom
(O'Brien, Gray) EMERGE (Emergency Medicine Research Group Edinburgh),
Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
(Oatey) Edinburgh Clinical Trials Unit, University of Edinburgh,
Edinburgh, United Kingdom
(Keating) Department of Emergency Medicine, Royal Berkshire Nhs Foundation
Trust, Reading, United Kingdom
(Storey) Division of Clinical Medicine, University of Sheffield,
Sheffield, United Kingdom
(Storey) NIHR Sheffield Biomedical Research Centre, Sheffield Teaching
Hospitals Nhs Foundation Trust, Sheffield, United Kingdom
(Felmeden) Department of Cardiology, Torbay and South Devon NHS Foundation
Trust, Torquay, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton, Southampton,
United Kingdom
(Curzen) Department of Cardiology, University Hospital Southampton NHS
Foundation Trust, Southampton, United Kingdom
(Kardos) TCRG (Translational Cardiovascular Research Group), Milton Keynes
University Hospital Nhs Foundation Trust, Milton Keynes, United Kingdom
(Roobottom) Department of Radiology, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Smith) Emergency Department, University Hospitals Plymouth NHS Trust,
Plymouth, United Kingdom
(Goodacre) School of Health and Related Research, University of Sheffield,
Sheffield, United Kingdom
(Gray) Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background: The HEART score, the T-MACS model and the GRACE score support
early decision-making for acute chest pain, which could be complemented by
CT coronary angiography (CTCA). However, their performance has not been
directly compared. <br/>Method(s): In this secondary analysis of a
multicentre randomised controlled trial of early CTCA in intermediate-risk
patients with suspected acute coronary syndrome, C-statistics and
performance metrics (using the predefined cut-offs) of clinical decision
aids and CTCA, alone and then in combination, for the index hospital
diagnosis of acute coronary syndrome and for 30-day coronary
revascularisation were assessed in those who underwent CTCA and had
complete data. <br/>Result(s): Among 699 patients, 358 (51%) had an index
hospital diagnosis of acute coronary syndrome, for which the C-statistic
was higher for CTCA (0.80), followed by the T-MACS model (0.78), the HEART
score (0.74) and the GRACE score (0.60). The negative predictive value was
higher for the absence of coronary artery disease on CTCA (0.90) or a
T-MACS estimate of <0.05 (0.83) than a HEART score of <4 (0.81) and a
GRACE score of <109 (0.55). For 30-day coronary revascularisation, CTCA
had the greatest C-statistic (0.80) with a negative predictive value of
0.96 and 0.92 in the absence of coronary artery disease and obstructive
coronary artery disease, respectively. The combination of the T-MACS
estimates and the CTCA findings was most discriminative for the index
hospital diagnosis of acute coronary syndrome (C-statistic, 0.88) and
predictive of 30-day coronary revascularisation (C-statistic, 0.85). No
patients with a T-MACS estimate of <0.05 and normal coronary arteries had
acute coronary syndrome during index hospitalisation or underwent coronary
revascularisation within 30 days. <br/>Conclusion(s): In intermediate-risk
patients with suspected acute coronary syndrome, the T-MACS model combined
with CTCA improved discrimination of the index hospital diagnosis of acute
coronary syndrome and prediction of 30-day coronary revascularisation.
<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2024. No commercial
re-use. See rights and permissions. Published by BMJ.

<20>
Accession Number
2030246756
Title
Transcatheter Therapy for the Tricuspid Valve: A Focused Review of
Edge-to-Edge Repair and Orthotopic Valve Replacement.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Madhavan M.V.; Agarwal V.; Hahn R.T.
Institution
(Madhavan, Agarwal, Hahn) NewYork-Presbyterian Hospital, Columbia
University Irving Medical Center, 177 Fort Washington Avenue, New York, NY
10032, United States
(Madhavan, Hahn) Cardiovascular Research Foundation, New York, NY, United
States
Publisher
Springer
Abstract
Purpose of Review: Patients with severe tricuspid regurgitation (TR) are
at risk for significant morbidity and mortality. Transcatheter tricuspid
valve interventions (TTVI) may offer patients less invasive treatment
alternatives to surgery. This review evaluates the most common class of
device currently used worldwide to treat TR, tricuspid transcatheter
edge-to-edge repair (T-TEER) and orthotopic transcatheter tricuspid valve
replacement (TTVR), both of which are now approved in the USA and Europe.
Recent Findings: The first pivotal randomized clinical trial, TRILUMINATE,
demonstrated that T-TEER can safely reduce TR and is associated with
improved health status outcomes. However, results of this trial have
raised questions about whether this device can provide sufficient TR
reduction to impact clinical outcomes. Orthotopic TTVR has recently gained
attention with initial data suggesting near-complete TR elimination.
<br/>Summary: The current review examines the technical features and
anatomic limitations of the most commonly used devices for T-TEER and
orthotopic TTVR, discusses the current clinical data for these devices,
and offers a theoretical construct for device selection.<br/>Copyright
&#xa9; The Author(s) 2024.

<21>
Accession Number
2031774883
Title
Ventilatory efficiency as a prognostic factor for postoperative
complications in patients undergoing elective major surgery: a systematic
review.
Source
British Journal of Anaesthesia. 133(1) (pp 178-189), 2024. Date of
Publication: July 2024.
Author
Vetsch T.; Eggmann S.; Jardot F.; von Gernler M.; Engel D.; Beilstein
C.M.; Wuethrich P.Y.; Eser P.; Wilhelm M.
Institution
(Vetsch, Jardot, Engel, Beilstein, Wuethrich) Department of
Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Vetsch, Eser, Wilhelm) Centre for Rehabilitation & Sports Medicine,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Vetsch) Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
(Eggmann) Department of Physiotherapy, Inselspital, Bern University
Hospital, Bern, Switzerland
(von Gernler) Medical Library, University Library of Bern, University of
Bern, Bern, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Major surgery is associated with high complication rates.
Several risk scores exist to assess individual patient risk before surgery
but have limited precision. Novel prognostic factors can be included as
additional building blocks in existing prediction models. A candidate
prognostic factor, measured by cardiopulmonary exercise testing, is
ventilatory efficiency (VE/VCO<inf>2</inf>). The aim of this systematic
review was to summarise evidence regarding VE/VCO<inf>2</inf> as a
prognostic factor for postoperative complications in patients undergoing
major surgery. <br/>Method(s): A medical library specialist developed the
search strategy. No database-provided limits, considering study types,
languages, publication years, or any other formal criteria were applied to
any of the sources. Two reviewers assessed eligibility of each record and
rated risk of bias in included studies. <br/>Result(s): From 10,082
screened records, 65 studies were identified as eligible. We extracted
adjusted associations from 32 studies and unadjusted from 33 studies. Risk
of bias was a concern in the domains 'study confounding' and 'statistical
analysis'. VE/VCO<inf>2</inf> was reported as a prognostic factor for
short-term complications after thoracic and abdominal surgery.
VE/VCO<inf>2</inf> was also reported as a prognostic factor for mid- to
long-term mortality. Data-driven covariable selection was applied in 31
studies. Eighteen studies excluded VE/VCO<inf>2</inf> from the final
multivariable regression owing to data-driven model-building approaches.
<br/>Conclusion(s): This systematic review identifies VE/VCO<inf>2</inf>
as a predictor for short-term complications after thoracic and abdominal
surgery. However, the available data do not allow conclusions about
clinical decision-making. Future studies should select covariables for
adjustment a priori based on external knowledge. Systematic review
protocol: PROSPERO (CRD42022369944).<br/>Copyright &#xa9; 2024 British
Journal of Anaesthesia

<22>
Accession Number
2029715461
Title
Clinical Significance of Coronary Arterial Dominance: A Review of the
Literature.
Source
Journal of the American Heart Association. 13(9) (no pagination), 2024.
Article Number: e032851. Date of Publication: 07 May 2024.
Author
Wu B.; Kheiwa A.; Swamy P.; Mamas M.A.; Tedford R.J.; Alasnag M.; Parwani
P.; Abramov D.
Institution
(Wu) Department of Medicine, Loma Linda University Medical Center, Loma
Linda, CA, United States
(Kheiwa, Swamy, Parwani, Abramov) Department of Cardiology, Loma Linda
University Medical Center, Loma Linda, CA, United States
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
(Tedford) Department of Medicine, Division of Cardiology, Medical
University of South Carolina, Charleston, SC, United States
(Alasnag) Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi
Arabia
Publisher
American Heart Association Inc.
Abstract
Coronary dominance describes the anatomic variation of coronary arterial
supply, notably as it relates to perfusion of the inferior cardiac
territories. Differences in the development and outcome in select disease
states between coronary dominance patterns are increasingly recognized. In
particular, observational studies have identified higher prevalence of
poor outcomes in left coronary dominance in the setting of ischemic,
conduction, and valvular disease. In this qualitative literature review,
we summarize anatomic, physiologic, and clinical implications of
differences in coronary dominance to highlight current understanding and
gaps in the literature that should warrant further studies.<br/>Copyright
&#xa9; 2024 The Authors. Published on behalf of the American Heart
Association, Inc., by Wiley.

<23>
Accession Number
2029708399
Title
The Postoperative Effects of Anesthesia Exposure on Cognitive Decline in
Older Adults: A Narrative Review.
Source
Current Alzheimer Research. 21(1) (pp 3-23), 2024. Date of Publication:
2024.
Author
Willoughby-Dudley K.A.; Darwin M.L.; Davalos D.B.
Institution
(Willoughby-Dudley, Darwin, Davalos) Department of Psychology, Colorado
State University, Fort Collins, CO, United States
Publisher
Bentham Science Publishers
Abstract
Background: As modern medicine continues to make strides in effective
surgical treatments, we must also consider the critical impact of
anesthesia on neuropsychological outcomes. Recent evidence suggests that
anesthesia exposure may be a risk factor for postoperative cognitive
decline and the eventual development of dementia. <br/>Objective(s): To
explore the vulnerability of the aging brain in the context of anesthesia
exposure in surgery, studies will be reviewed, and pertinent findings will
be highlighted and explored to better understand risks and possible
factors that need to be considered when contemplating surgery.
<br/>Method(s): A narrative review was conducted using a combination of
MEDLINE and APA PsycINFO databases to shed light on themes across studies
assessing general trends regarding the influence of anesthesia on
postoperative cognitive decline. <br/>Result(s): A search of relevant
literature identified 388 articles. Excluding results outside the
parameters of this study, the review includes quality assessments for 24
articles. <br/>Conclusion(s): While findings are inconclusive, suggestions
for further investigation into the relationship between anesthesia
exposure and increased risk for postoperative cognitive decline are
discussed, in addition to factors that may allow for greater informed
disclosure of potential risks of anesthesia in older adults.<br/>Copyright
&#xa9; 2024 Bentham Science Publishers.

<24>
Accession Number
2028899699
Title
Acupuncture reduces mechanical ventilation time in critically ill
patients: A systematic review and meta-analysis of randomized control
trials.
Source
Explore. 20(4) (pp 477-492), 2024. Date of Publication: 01 Jul 2024.
Author
Ben-Arie E.; Mayer P.K.; Lottering B.J.; Ho W.-C.; Lee Y.-C.; Kao P.-Y.
Institution
(Ben-Arie, Lottering, Lee) Graduate Institute of Acupuncture Science,
College of Chinese Medicine, China Medical University, Taichung 40402,
Taiwan (Republic of China)
(Mayer) International Master Program in Acupuncture, College of Chinese
Medicine, China Medical University, Taichung 40402, Taiwan (Republic of
China)
(Mayer) Department of Chinese Medicine, China Medical University Hospital,
Taichung 40402, Taiwan (Republic of China)
(Ho) Department of Public Health, China Medical University, Taichung
40402, Taiwan (Republic of China)
(Lee) Department of Acupuncture, China Medical University Hospital,
Taichung 40402, Taiwan (Republic of China)
(Lee) Chinese Medicine Research Center, China Medical University, Taichung
40402, Taiwan (Republic of China)
(Kao) Surgical Intensive Care Unit, China Medical University Hospital,
Taichung 40402, Taiwan (Republic of China)
(Kao) Division of Thoracic Surgery, Department of Surgery, China Medical
University Hospital, Taichung 40402, Taiwan (Republic of China)
(Kao) Institute of Traditional Medicine, School of Medicine, National Yang
Ming Chiao Tung University, Taipei 112304, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Background: Mechanical Ventilation (MV) is an essential life support
machine, frequently utilized in an Intensive Care Unit (ICU). Recently, a
growing number of clinical trials have investigated the effect of
acupuncture treatment on MV outcomes. <br/>Objective(s): This study
investigated the safety and efficacy of acupuncture treatment for
critically ill patients under MV. <br/>Method(s): In this systematic
review and meta-analysis of randomized controlled trials, the efficacy of
acupuncture related interventions was compared to routine ICU treatments,
and sham/control acupuncture as control interventions applied to ICU
patients undergoing MV. The databases of PubMed, Cochrane Library, and Web
of Science were extensively searched in the month of April 2022. The
primary outcome measurements were defined as total MV time, ICU length of
stay, and mortality. The Cochrane Collaboration risk of bias tool was
employed to analyze the severity of bias. The meta-analysis was conducted
using Review Manager 5.3 software. The quality of evidence was evaluated
according to the GRADE approach. <br/>Result(s): A total of 10 clinical
trials were included in this investigation. When comparing the performance
of acupuncture-related interventions to that of the reported control
interventions, the results of the meta-analysis revealed a significant
reduction in the total number of MV days as well as the duration of ICU
length of stay following acupuncture treatment (MD -2.06 [-3.33, -0.79] P
= 0.001, I² = 55 %, MD-1.26 [-2.00, -0.53] P = 0.0008,
I² = 77 %, respectively). A reduction in the total mortality
was similarly observed (RR = 0.67 [0.47, 0.94] P = 0.02, I² = 0
%). <br/>Conclusion(s): This systematic review and meta-analysis
identified a noteworthy reduction in the total MV days, time spent in the
ICU, as well as the total mortality following acupuncture related
interventions. However, the small sample size, risk of bias and existing
heterogeneity should be taken into consideration. The results of this
study are promising and further investigations in this field are
warranted.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<25>
Accession Number
2025173316
Title
Success and complication rates of conduction system pacing: a
meta-analytical observational comparison of left bundle branch area pacing
and His bundle pacing.
Source
Journal of Interventional Cardiac Electrophysiology. 67(4) (pp 719-729),
2024. Date of Publication: June 2024.
Author
Parlavecchio A.; Vetta G.; Coluccia G.; Pistelli L.; Caminiti R.; Crea P.;
Ajello M.; Magnocavallo M.; Dattilo G.; Foti R.; Carerj S.; Chierchia
G.B.; de Asmundis C.; Della Rocca D.G.; Palmisano P.
Institution
(Parlavecchio, Vetta, Pistelli, Caminiti, Crea, Ajello, Dattilo, Carerj)
Cardiology Unit, Department of Clinical and Experimental Medicine,
University of Messina, Via Consolare Valeria, 1, Messina 98124, Italy
(Coluccia, Palmisano) Cardiology Unit, "Card. G. Panico" Hospital, Via S.
Pio X, Tricase 73039, Italy
(Magnocavallo) Arrhythmology Unit, Ospedale San Giovanni Calibita,
Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, Rome 00186,
Italy
(Foti) San Vincenzo Hospital, Taormina, Italy
(Chierchia, de Asmundis, Della Rocca) Heart Rhythm Management Centre,
Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair
Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks
Guard-Heart, Brussels, Belgium
Publisher
Springer
Abstract
Background: Left bundle branch area pacing (LBBAP) and His bundle pacing
(HBP) are the main strategies to achieve conduction system pacing (CSP),
but only observational studies with few patients have compared the two
pacing strategies, sometimes with unclear results given the different
definitions of the feasibility and safety outcomes. Therefore, we
conducted a meta-analysis aiming to compare the success and complications
of LBBAP versus HBP. <br/>Method(s): We systematically searched the
electronic databases for studies published from inception to March 22,
2023, and focusing on LBBAP versus HBP. The study endpoints were CSP
success rate, device-related complications, CSP lead-related complications
and non-CSP lead-related complications. <br/>Result(s): Fifteen
observational studies enrolling 2491 patients met the inclusion criteria.
LBBAP led to a significant increase in procedural success [91.1% vs 80.9%;
RR: 1.15 (95% CI: 1.08-1.22); p < 0.00001] with a significantly lower
complication rate [1.8% vs 5.2%; RR: 0.48 (95% CI: 0.29-0.78); p = 0.003],
lead-related complications [1.1% vs 4.3%; RR: 0.38 (95% CI: 0.21-0.72); p
= 0.003] and lead failure/deactivation [0.2% vs 3.9%; RR: 0.16 (95% CI:
0.07-0.35); p < 0.00001] than HBP. No significant differences were found
between CSP lead dislodgement and non-CSP lead-related complications.
<br/>Conclusion(s): This meta-analysis of observational studies showed a
higher success rate of LBBAP compared to HBP with a lower incidence of
complications.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2023.

<26>
Accession Number
2032785299
Title
Efficacy and safety of trans-catheter repair devices for mitral
regurgitation: A systematic review and meta-analysis.
Source
International Journal of Cardiology. 411 (no pagination), 2024. Article
Number: 132245. Date of Publication: 15 Sep 2024.
Author
D'Amario D.; Laborante R.; Mennuni M.; Adamo M.; Metra M.; Patti G.
Institution
(D'Amario, Mennuni, Patti) Department of Translational Medicine,
Universita del Piemonte Orientale, Novara, Italy
(D'Amario, Mennuni, Patti) Division of Cardiology, AOU Maggiore della
Carita, Novara, Italy
(Laborante) Department of Cardiovascular and Thoracic Sciences, Fondazione
Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
(Adamo, Metra) Cardiology, ASST Spedali Civili, Brescia; Department of
Medical and Surgical Specialties, Radiological Sciences and Public Health,
University of Brescia, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Several repair strategies emerged as possible treatment for
severe mitral regurgitation (MR). A systematic review and meta-analysis
was performed to compare the different percutaneous mitral valve repair
approaches. <br/>Method(s): PubMed and Scopus electronic databases were
scanned for eligible studies until December 11th, 2023. Clinical efficacy
endpoints were all-cause mortality, major adverse cardiovascular events,
and post-procedural NYHA functional class <3; the echocardiographic
efficacy endpoint was a post-intervention residual MR less than moderate.
Safety endpoints and procedural outcome measures were also assessed.
<br/>Result(s): Eleven studies were included: 8 [N = 1662 patients, mean
follow-up (FUP) 294 days] compared MitraClip vs Pascal device, 2 (N = 195
patients) MitraClip vs Carillon and 1 study (N = 186 patients) evaluated
MitraClip against Cardioband. The Pascal-treated group had lower MR degree
compared to the MitraClip-treated group, without difference in
post-intervention mean trans-mitral gradient and in clinical and safety
endpoints. A longer procedure time was observed in the Pascal group,
albeit with a lower average number of implanted devices per procedure. The
two studies comparing MitraClip and Carillon were inconsistent in terms of
both efficacy and safety outcomes, while the study evaluating MitraClip vs
Cardioband showed that the latter might confer a significant clinical
benefit, with a similar reduction in MR. <br/>Conclusion(s): Pascal is as
safe and clinically effective as MitraClip in treating patients with MR,
with an apparent greater reduction in the magnitude of residual valve
insufficiency over the long term. Data on Cardioband and Carillon are not
robust enough to draw conclusions from the use of such
devices.<br/>Copyright &#xa9; 2024

<27>
Accession Number
2032488711
Title
Daptomycin-Induced Eosinophilic Pneumonia: A Case Report and Systematic
Review.
Source
Chemotherapy. 69(2) (pp 85-99), 2023. Date of Publication: 14 Nov 2023.
Author
Di Lorenzo A.; Rindi L.V.; Campogiani L.; Imeneo A.; Alessio G.; Pace
P.G.; Lodi A.; Rossi B.; Crea A.M.A.; Vitale P.; Kontogiannis D.;
Malagnino V.; Andreoni M.; Iannetta M.; Sarmati L.
Institution
(Di Lorenzo, Rindi, Imeneo, Alessio, Pace, Lodi, Kontogiannis, Malagnino,
Andreoni, Iannetta, Sarmati) Tor Vergata University, Rome, Italy
(Campogiani, Crea, Vitale, Malagnino, Andreoni, Iannetta, Sarmati)
Department of Systems Medicine, Infectious Disease Clinic, Rome, Italy
(Rossi) Camerino University, Camerino, Italy
(Rossi) University of Brescia, Brescia, Italy
Publisher
S. Karger AG
Abstract
Introduction: Acute eosinophilic pneumonia (AEP) is a rare respiratory
condition caused by eosinophil accumulation in the pulmonary tissue that
can be related to drug administration. Daptomycin, an antibiotic active
against gram-positive bacteria, is one of the leading causes of AEP among
drugs. In order to raise awareness of this rare syndrome, in our work we
have described a case of an 82-year-old male with Enterococcus faecalis
endocarditis treated with daptomycin, who developed a daptomycin-induced
AEP. We have performed a systematic review of the literature for all
similar reported cases. <br/>Method(s): The systematic review was
performed according to the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) statement. To conduct the analysis, the
terms "daptomycin AND eosinoph* AND pneum*"were entered into the databases
Medline, CINAHL, and Embase on April 13, 2023. We considered all relevant
records documenting AEP after daptomycin use. No restrictions in terms of
year or language were made. A formal appraisal of observational studies
was performed by Newcastle-Ottawa Scale. All results and data were
reported by means of tables. <br/>Result(s): Our search identified 93
relevant records, published between 2007 and 2023. A total of 120 patients
were considered. Patients who experienced AEP were mostly males (n = 88,
73.3%) with a mean age of 68.28 years (SD 11.54). Daptomycin was most
frequently prescribed for osteoarticular infections (n = 75, 62.5%) and to
treat gram-positive cocci infections. The most frequently isolated
pathogen was methicillin-resistant Staphylococcus aureus. Daptomycin was
mostly used with off-label indications (n = 89, 74%). Symptoms of AEP were
usually reported after a mean of 21.75 days of treatment (range 3-84) and
typically included fever, dyspnea, dry cough, and acute respiratory
failure. Reported treatment strategies invariably included daptomycin
withdrawal, respiratory support, and corticosteroid treatment. One hundred
and sixteen patients fully recovered. A fatal outcome was described in 4
patients. Suggestive symptoms and imaging raised suspicion for AEP,
confirmed with bronchoalveolar lavage in 57.5% of the cases. Discussion
and <br/>Conclusion(s): Daptomycin-induced AEP is a rare but potentially
fatal complication, mostly reported after long treatment with daptomycin.
Clinicians should be aware of this syndrome, as it could be initially
misdiagnosed for an acute infectious respiratory syndrome, resulting in a
delay in its diagnosis and treatment. Furthermore, since the risk of
developing AEP is increased by longer drug exposure, caution should be
used when discussing the use of daptomycin in longer treatment
regimens.<br/>Copyright &#xa9; 2023 The Author(s). Published by S. Karger
AG, Basel.

<28>
Accession Number
2029871101
Title
Managing chronic coronary syndrome: how do we achieve optimal patient
outcomes?.
Source
Expert Review of Cardiovascular Therapy. 22(6) (pp 243-263), 2024. Date of
Publication: 2024.
Author
Manolis A.A.; Manolis T.A.; Manolis A.S.
Institution
(Manolis) Department of Medicine, Elpis General Hospital, Athens, Greece
(Manolis) Department of Psychiatry, Aiginiteio University Hospital,
Athens, Greece
(Manolis) First Department of Cardiology, Ippokrateio University Hospital,
Athens, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Chronic coronary syndrome (CCS) remains the leading cause of
death worldwide with high admission/re-admission rates. Medical databases
were searched on CCS & its management. Areas covered: This review
discusses phenotypes per stress-echocardiography, noninvasive/invasive
testing (coronary computed-tomography angiography-CCTA; coronary artery
calcium-CAC score; echocardiography assessing wall-motion, LV function,
valvular disease; biomarkers), multidisciplinary management (risk
factors/anti-inflammatory/anti-ischemic/antithrombotic therapies and
revascularization), newer treatments
(colchicine/ivabradine/ranolazine/melatonin), cardiac
rehabilitation/exercise improving physical activity and quality-of-life,
use of the implantable-defibrillator, and treatment with extracorporeal
shockwave-revascularization for refractory symptoms. Expert opinion: CCS
is age-dependent, leading cause of death worldwide with high
hospitalization rates. Stress-echocardiography defines phenotypes and
guides prophylaxis and management. CAC is a surrogate for atherosclerosis
burden, best for patients of intermediate/borderline risk. Higher
CAC-scores indicate more severe coronary abnormalities. CCTA is preferred
for noninvasive detection of CAC and atherosclerosis burden, determining
stenosis' functional significance, and guiding management. Combining CAC
score with CCTA improves diagnostic yield and assists prognosis.
Echocardiography assesses LV wall-motion and function and valvular
disease. Biomarkers guide diagnosis/prognosis. CCS management is
multidisciplinary: risk-factor management,
anti-inflammatory/anti-ischemic/antithrombotic therapies, and
revascularization. Newer therapies comprise colchicine, ivabradine,
ranolazine, melatonin, glucagon-like peptide-1-receptor antagonists.
Cardiac rehabilitation/exercise improves physical activity and
quality-of-life. An ICD protects from sudden death. Extracorporeal
shockwave-revascularization treats refractory symptoms.<br/>Copyright
&#xa9; 2024 Informa UK Limited, trading as Taylor & Francis Group.

<29>
Accession Number
2028938467
Title
Prevalence of spinal deformity development after surgical management of a
congenital heart disease among children: a systematic review and
meta-analysis.
Source
European Spine Journal. 33(5) (pp 2088-2096), 2024. Date of Publication:
May 2024.
Author
Balubaid R.N.; Aljedani R.S.; Moglan A.; Hennawi Y.B.; Mousa A.H.;
Alosaimi M.
Institution
(Balubaid, Aljedani, Moglan, Alosaimi) College of Medicine, King Saud Bin
Abdulaziz University For Health Sciences, Jeddah, Saudi Arabia
(Hennawi) Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi
Arabia
(Mousa) College of Medicine and Surgery, Batterjee Medical College,
Jeddah, Saudi Arabia
(Balubaid, Aljedani, Moglan, Hennawi, Mousa, Alosaimi) King Abdullah
International Medical Research Center, Jeddah, Saudi Arabia
(Alosaimi) Department of Orthopedic, King Abdulaziz Medical City, Jeddah,
Saudi Arabia
(Alosaimi) King Khalid National Guard Hospital, King Abdulaziz Medical
City, National Guard, Jeddah, Saudi Arabia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Open heart surgery is the most common treatment for
congenital heart disease. Thoracotomy, sternotomy, or a combination of
both are the main approaches used in open heart surgeries. In cardiac
surgery, there have been concerns that these surgeries increase the
likelihood of spinal deformities. Therefore, this systematic review and
meta-analysis provided updated evidence on the prevalence of spinal
deformities following congenital heart surgery. <br/>Method(s): EMBASE,
Medline, ScienceDirect, and Google Scholar were used to search for studies
published until 2022. We include randomized clinical trials and
observational studies that reported the prevalence of spinal deformities
(scoliosis and kyphosis) after congenital heart surgery among participants
without these deformities before surgery. Two independent reviewers
independently screened literature identified from the databases. Two
reviewers independently conducted screening of studies identified during
the search, data extraction, and quality assessment of the included
studies. <br/>Result(s): In total, 688 studies were screened; 13
retrospective and one prospective cohort studies were included,
encompassing 2294 participants. The pooled prevalence of spinal
deformities (scoliosis and kyphosis) after open heart surgery performed on
skeletally immature patients was 23.1% (95% confidence interval [CI] =
23.1-35.3; I² = 97.5%). <br/>Conclusion(s): This review
suggests that the prevalence of spinal deformities was high among patients
who underwent sternotomy or thoracotomy.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature 2024.

<30>
Accession Number
2032812972
Title
Effect of varying cuff sizes with identical inner diameter on endotracheal
intubation in critically ill adults A sealed tracheal controlled trial.
Source
Medicine (United States). 103(24) (no pagination), 2024. Date of
Publication: 14 Jun 2024.
Author
Yan-Nan Z.; Hai-Yan S.; Wang-Qin S.; Jia-Hai S.; Yan-Ping Z.; Yang-Hui X.;
Hong-Lei W.
Institution
(Yan-Nan, Yang-Hui, Hong-Lei) Nursing Department, Affiliated Hospital of
Nantong University, Jiangsu, Nantong, China
(Hai-Yan) Nursing Department, The People's Hospital of Rugao, Affiliated
Rugao Hospital of Nantong University, Jiangsu, Nantong City, China
(Wang-Qin) Nursing Department, Nantong Third People's Hospital, Jiangsu,
Nantong, China
(Jia-Hai) Department of Cardiothoracic Surgery, Affiliated Hospital of
Nantong University, Jiangsu, Nantong, China
(Yan-Ping) Intensive Care Unit, Southeast University Affiliated Zhong Da
Hospital, Jiangsu, Nanjing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The present study aims to determine the impact of different
cuff diameters on the cuff pressure of endotracheal tubes (ETTs) when the
trachea is adequately sealed. <br/>Method(s): In the present single-center
clinical trial, adult patients who underwent cardiothoracic surgery were
assigned to use ETTs from 2 brands (GME and GZW). The primary endpoint
comprised of the following: cuff diameter, inner diameter of the ETT,
manufacturer, and the number of subjects with tracheal leakage when the
cuff pressure was 30 cm H<inf>2</inf>O. <br/>Result(s): A total of 298
patients were assigned into 2 groups, based on the 2 distinct brands of
ETTs: experimental group (n = 122, GME brand) and control group (n = 176,
GZW brand). There were no significant differences in baseline
characteristics. However, the cuff diameter was significantly smaller in
the control group, when compared to the experimental group (P = .001), and
the incidence of tracheal leakage was significantly higher in the control
group (P = .001). Furthermore, the GME brand ETT had a significantly
larger cuff diameter, when compared to the GZW brand ETT.
<br/>Conclusion(s): The cuff size would mismatch the tracheal area in
clinical practice. Therefore, chest computed tomography is recommended to
routinely evaluate the tracheal cross-sectional area during anesthesia, in
order to ensure the appropriate cuff size selection.<br/>Copyright &#xa9;
2024 Lippincott Williams and Wilkins. All rights reserved.

<31>
Accession Number
2032800235
Title
Effect of Respiratory Proprioceptive Neuromuscular Facilitation in Phase
One Cardiac Rehabilitation - A Randomized Controlled Trial.
Source
Nepalese Heart Journal. 21(1) (pp 3-9), 2024. Date of Publication: May
2024.
Author
Naik V.; Vernekar S.
Institution
(Naik, Vernekar) Department of Cardiovascular and Pulmonary Physiotherapy,
KAHER Institute of Physiotherapy, Karnataka, Belagavi, India
Publisher
Cardiac Society of Nepal
Abstract
Background: Patients undergoing coronary artery bypass graft (CABG) and
valve replacement surgery often develop pulmonary complications in early
post-operative period as results of decreased lung function and impaired
cough reflex. The recent study aimed to determine and compare
effectiveness of respiratory PNF to conventional physiotherapy in
improving the pulmonary function and airway clearance in early period of
CABG and valve replacement patients. <br/>Method(s): A Randomized control
trial was conducted on 46 subjects with median sternotomy incision.
Participants were assigned to either Group A (n=23) received phase one of
cardiac rehabilitation or Group B (n=23) received phase one of cardiac
rehabilitation and respiratory PNF. The sessions were carried for 30 min
for five consecutive days twice a day. Outcome measure in the present
study were peak flow meter, thoracic expansion, sputum volume, respiratory
rate, heart rate and blood pressure. The outcome measures were evaluated
on baseline and post 5 days of the intervention. <br/>Result(s): within
group analysis revealed that both the interventional and control groups
improved significantly on all outcome measure with p-value less (p<0.005)
than in all parameters expect for blood pressure, whereas a significant
difference was seen in between group analysis in blood pressure (0.0500)
and hear rate (0.0210). <br/>Conclusion(s): the study concluded that phase
one cardiac rehabilitation along with respiratory PNF are effective in
improving the lung function, rate and depth of breathing, sputum
clearance.<br/>Copyright &#xa9; 2024 Cardiac Society of Nepal. All rights
reserved.

<32>
Accession Number
644512091
Title
Effects of omega-3 fatty acids on coronary revascularization and
cardiovascular events: a meta-analysis.
Source
European journal of preventive cardiology. (no pagination), 2024. Date of
Publication: 13 Jun 2024.
Author
Dinu M.; Sofi F.; Lotti S.; Colombini B.; Mattioli A.V.; Catapano A.L.;
Casula M.; Baragetti A.; Wong N.D.; Steg P.G.; Ambrosio G.
Institution
(Dinu, Sofi, Lotti, Colombini) Department of Experimental and Clinical
Medicine, University of Florence, Florence, Italy
(Sofi) Unit of Clinical Nutrition, Careggi University Hospital, Florence,
Italy
(Mattioli) Department of Medical and Surgical Sciences, University of
Modena and Reggio Emilia, Modena, Italy
(Catapano, Casula, Baragetti) IRCCS MultiMedica, Milan, Italy
(Catapano, Casula, Baragetti) Department of Pharmacological and
Biomolecular Sciences, University of Milan, Milan, Italy
(Wong) Division of Cardiology, University of California, Irvine, United
States
(Steg) INSERM U1148, FACT French Alliance for Cardiovascular Trials, AP-HP
Hopital Bichat, Paris, France
(Ambrosio) Division of Cardiology, Center for Clinical and Translational
Research-CERICLET, University of Perugia School of Medicine, Ospedale S.
Maria della Misericordia, Via S. Andrea delle Fratte, Perugia 06156, Italy
Abstract
AIMS: Benefits of pharmacologic omega-3 fatty acid administration in
cardiovascular prevention are controversial. Particularly, effects on
coronary revascularization are unclear; also debated are specific benefits
of eicosapentaenoic acid (EPA). We investigated incident coronary
revascularizations, myocardial infarction (MI), stroke, heart failure
(HF), unstable angina, and cardiovascular death, in subjects randomized to
receive EPA or EPA + docosahexaenoic acid (EPA + DHA) vs. control. METHODS
AND RESULTS: Meta-analysis of randomized controlled trials (RCTs) was
conducted after MEDLINE, Embase, Scopus, Web of Science, and Cochrane
Library search. Preferred Reporting Items for Systematic Reviews and
Meta-analysis guidelines were followed for abstracting data and assessing
data quality and validity. Data were pooled using a random effects model.
Eighteen RCTs with 134 144 participants (primary and secondary
cardiovascular prevention) receiving DHA + EPA (n = 52 498), EPA alone (n
= 14 640), or control/placebo (n = 67 006) were included. Follow-up ranged
from 4.5 months to 7.4 years. Overall, compared with controls, omega-3
supplementation reduced the risk of revascularization [0.90, 95%
confidence interval (CI) 0.84-0.98; P = 0.001; P-heterogeneity = 0.0002;
I2 = 68%], MI (0.89, 95% CI 0.81-0.98; P = 0.02; P-heterogeneity = 0.06;
I2 = 41%), and cardiovascular death (0.92, 95% CI 0.85-0.99; P = 0.02;
P-heterogeneity = 0.13; I2 = 33%). Lower risk was still observed in trials
where most participants (>=60%) were on statin therapy. Compared with DHA
+ EPA, EPA alone showed a further significant risk reduction of
revascularizations (0.76, 95% CI 0.65-0.88; P = 0.0002; P-interaction =
0.005) and all outcomes except HF. <br/>CONCLUSION(S): Omega-3 fatty acid
supplementation reduced the risk of cardiovascular events and coronary
revascularization, regardless of background statin use. Eicosapentaenoic
acid alone produced greater benefits. The role of specific omega-3
molecules in primary vs. secondary prevention and the potential benefits
of reduced revascularizations on overall health status and cost savings
warrant further research.<br/>Copyright &#xa9; The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<33>
Accession Number
644511755
Title
The prognostic value of peak oxygen uptake in obstructive hypertrophic
cardiomyopathy: A literature review to inform economic model development.
Source
Journal of medical economics. (pp 1-14), 2024. Date of Publication: 13
Jun 2024.
Author
Butzner M.; Kinyik-Merena C.; Aguiar M.; Davison N.; Shreay S.; Masri A.
Institution
(Butzner, Shreay) Cytokinetics, Inc., 350 Oyster Point Blvd., South San
Francisco, CA, United States
(Kinyik-Merena, Aguiar, Davison) Maple Health Group, 1740 Broadway, New
York, NY
(Masri) Division of Cardiology, Oregon Health and Science University, 3181
SW Sam Jackson Park Rd
Abstract
Aims: Patients with obstructive hypertrophic cardiomyopathy (oHCM)
experience significant clinical burden which is associated with a high
economic burden. Peak oxygen uptake (pVO2), measured by cardiopulmonary
exercise testing, is used to quantify functional capacity, and has been
studied as a primary endpoint in recent clinical trials. This study aimed
to gather evidence to consolidate the prognostic value of pVO2 in oHCM and
to assess whether it is feasible to predict health outcomes in an economic
model based on changes in pVO2. <br/>Method(s): A targeted literature
review was conducted in MEDLINE (via PubMed) and Embase databases to
identify evidence on the prognostic value of pVO2 as a surrogate health
outcome to support future oHCM economic model development. Following
screening, study characteristics, population characteristics and pVO2
prognostic association data were extracted. <br/>Result(s): A total of
4,687 studies were identified. 3,531 and 538 studies underwent
title/abstract and full-text screening, respectively, of which 151 were
included and 9 of these were in hypertrophic cardiomyopathy (HCM); only 3
studies focused on oHCM. The 9 HCM studies consisted of 1 systematic
literature review and 8 primary studies reporting on 27 potentially
predictive relationships from a pVO2-based metric with clinical outcomes
including all-cause mortality, cardiovascular mortality, sudden cardiac
death, transplant, paroxysmal and permanent atrial fibrillation. pVO2 was
described as a predictor of single and composite endpoints, in 3 and 6
studies respectively, with 1 study reporting on both. <br/>Limitation(s):
This study primarily uses systemic literature review methods but does not
qualify as one due to not entailing parallel reviewers during
title-abstract and full-text stages of review. <br/>Conclusion(s): The
findings of this study suggest pVO2 is predictive of multiple health
outcomes, providing rationale to use pVO2 in the development of an
economic model.

<34>
Accession Number
644511143
Title
Acute normovolemic hemodilution in cardiac surgery: Rationale and design
of a multicenter randomized trial.
Source
Contemporary clinical trials. (pp 107605), 2024. Date of Publication: 10
Jun 2024.
Author
Monaco F.; Guarracino F.; Vendramin I.; Lei C.; Zhang H.; Lomivorotov V.;
Osinsky R.; Efremov S.; Gurcu M.E.; Mazzeffi M.; Pasyuga V.; Kotani Y.;
Biondi-Zoccai G.; D'Ascenzo F.; Romagnoli E.; Neto C.N.; Do Nascimento
V.T.N.D.S.; Ti L.K.; Lorsomradee S.; Farag A.; Bukamal N.; Brizzi G.;
Lobreglio R.; Belletti A.; Arangino C.; Paternoster G.; Bonizzoni M.A.;
Tucciariello M.T.; Kroeller D.; Di Prima A.L.; Mantovani L.F.; Ajello V.;
Gerli C.; Porta S.; Ferrod F.; Giardina G.; Santonocito C.; Ranucci M.;
Lembo R.; Pisano A.; Morselli F.; Nakhnoukh C.; Oriani A.; Pieri M.;
Scandroglio A.M.; Kirali K.; Likhvantsev V.; Longhini F.; Yavorovskiy A.;
Bellomo R.; Landoni G.; Zangrillo A.
Institution
(Monaco) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy; I.M. Sechenov First Moscow State
Medical University, Ministry of Public Health of Russia, Moscow, Russia
(Guarracino, Brizzi) Department of Cardiothoracic Anesthesia and ICU,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Vendramin) Division of Cardiac Surgery, Azienda Sanitaria Universitaria
Friuli Centrale, Udine, Italy; Department of Medicine, University of
Udine, Udine, Italy
(Lei, Zhang) Department of Anesthesiology and Perioperative Medicine,
Xijing Hospital, Xi'an, China
(Lomivorotov) E. Meshalkin National Medical Research Center, Department of
Anesthesiology and Intensive Care, Novosibirsk, Russia; Penn State Milton
S. Hershey Medical Center, Department of Anesthesiology and Perioperative
Medicine, Hershey, PA, USA
(Osinsky) E. Meshalkin National Medical Research Center, Department of
Anesthesiology and Intensive Care, Novosibirsk, Russian Federation
(Efremov) Saint Petersburg State University Hospital, Saint-Petersburg,
Russian Federation
(Gurcu) Kosuyolu High Specialization Education and Research Hospital,
Istanbul, Turkey
(Mazzeffi) Department of Anesthesiology, University of Virginia School of
Medicine, Charlottesville, VA, United States
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Kotani) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy; Department of Intensive Care Medicine,
Kameda Medical Center, Kamogawa, Japan
(Biondi-Zoccai) Sapienza University of Rome, Latina, Italy; Mediterranea
Cardiocentro, Napoli, Italy
(D'Ascenzo) Cardiovascular and Thoracic Department, A.O.U. Citta della
Salute e della Scienza, Turin, Italy; Department of Medical Sciences,
University of Turin, Turin, Italy
(Romagnoli) Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Via Pineta Sacchetti, 217, 00168 Rome, Italy; Universita Cattolica del
Sacro Cuore, Campus di Roma, Largo Francesco Vito, 1, 00168, Rome, Italy
(Neto, Do Nascimento) Dante Pazzanese Institute of Cardiology, Sao Paulo,
Brazil
(Ti) National University Hospital, Singapore
(Lorsomradee) Chiang Mai University Hospital, Chiang Mai, Thailand
(Farag) King Abdullah Medical City - Holy Capital (KAMC-HC), Makkah, Saudi
Arabia
(Bukamal) Cardiothoracic ICU and Anesthesia Department, Mohammed Bin
Khalifa Specialist Cardiac Center, Bahrain
(Lobreglio) Department of Anesthesia, Intensive Care and Emergency, Citta
della Salute e della Scienza University Hospital, Turin, Italy
(Belletti, Bonizzoni, Di Prima, Gerli, Giardina, Lembo, Morselli,
Nakhnoukh, Oriani, Pieri, Scandroglio) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Arangino) Department of Cardiothoracic Anesthesia and Intensive Care,
IRCCS Centro Cardiologico Monzino, Milan, Italy
(Paternoster, Tucciariello) Cardiovascular Anesthesia and Intensive Care,
San Carlo Hospital, Potenza, Italy
(Kroeller) IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
(Mantovani) Maria Cecilia Hospital GVM Care and research, Cotignola, Italy
(Ajello) Department of Cardio Thoracic anesthesia and Intensive Care,
Hospital Tor Vergata Roma, Italy
(Porta) Anestesia Rianimazione, Terapia Intensiva e Del Dolore, Turin,
Italy
(Ferrod) Department of Cardiovascular Anestesia, Turin, Italy
(Santonocito) Anaesthesia and Intensive Care Medicine III, Policlinico
University Hospital, Catania, Italy
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Italy
(Pisano) Cardiac Anesthesia and Intensive Care Unit, Monaldi Hospital,
Azienda Ospedaliera Dei Colli, Naples, Italy
(Kirali) Department of Medical Sciences, University of Turin, Turin, Italy
(Likhvantsev) Department of Clinical Trials, V. Negovsky Reanimatology
Research Institute, Moscow, Russian Federation; Department of
Anesthesiology and Resuscitation, First Moscow State Medical University,
Moscow, Russian Federation
(Longhini) Anesthesia and Intensive Care, Department of Medical and
Surgical Sciences, Magna Graecia University of Catanzaro, Italy
(Yavorovskiy) Department of Intensive Care Medicine, Kameda Medical
Center, Kamogawa, Japan
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia; Australian and New Zealand Intensive Care Research
Centre, Monash University, Melbourne, Australia
(Landoni, Zangrillo) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele
University, Milan, Italy
Abstract
BACKGROUND: Minimizing the use of blood component can reduce known and
unknown blood transfusion risks, preserve blood bank resources, and
decrease healthcare costs. Red Blood Cell (RBC) transfusion is common
after cardiac surgery and associated with adverse perioperative outcomes,
including mortality. Acute normovolemic hemodilution (ANH) may reduce
bleeding and the need for blood product transfusion after cardiac surgery.
However, its blood-saving effect and impact on major outcomes remain
uncertain. <br/>METHOD(S): This is a single-blinded, multinational,
pragmatic, randomized controlled trial with a 1:1 allocation ratio
conducted in Tertiary and University hospitals. The study is designed to
enroll patients scheduled for elective cardiac surgery with planned
cardiopulmonary bypass (CPB). Patients are randomized to receive ANH
before CPB or the best available treatment without ANH. We identified an
ANH volume of at least 650mL as the critical threshold for clinically
relevant benefits. Larger ANH volumes, however, are allowed and tailored
to the patient's characteristics and clinical conditions. <br/>RESULT(S):
The primary outcome is the percentage of patients receiving RBCs
transfusion from randomization until hospital discharge, which we
hypothesize will be reduced from 35% to 28% with ANH. Secondary outcomes
are all-cause 30-day mortality, acute kidney injury, bleeding
complications, and ischemic complications. <br/>CONCLUSION(S): The trial
is designed to determine whether ANH can safely reduce RBC transfusion
after elective cardiac surgery with CPB. STUDY REGISTRATION: This trial
was registered on ClinicalTrials.gov in April 2019 with the trial
identification number NCT03913481.<br/>Copyright &#xa9; 2024. Published by
Elsevier Inc.

<35>
Accession Number
2028114393
Title
Effect of colchicine on perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery in patients undergoing major thoracic
surgery (COP-AF): an international randomised trial.
Source
The Lancet. 402(10413) (pp 1627-1635), 2023. Date of Publication: 04 Nov
2023.
Author
Conen D.; Ke Wang M.; Popova E.; Chan M.T.V.; Landoni G.; Reimer C.; Reyes
J.C.T.; Grande A.M.; Tallada A.G.; Fleischmann E.; Kabon B.; Voltolini L.;
Cruz P.; Gutierrez-Soriano L.; Tandon V.; Martinez-Tellez E.;
Guerra-Londono J.J.; DuMerton D.; Wong R.H.L.; McGuire A.L.; Kidane B.;
Roux D.P.; Shargall Y.; Vincent J.; Xu L.; Li Z.; Jolly S.S.; Healey J.S.;
Devereaux P.J.; Wang M.K.; Wells J.R.; McIntyre W.F.; Sessler D.I.;
Srinathan S.K.; Amir M.; Bangdiwala S.I.; Bossard M.; Chan M.T.; Eikelboom
J.W.; Jolly S.; Montes F.R.; Schmartz D.; Wang C.Y.; Ofori S.N.; Blum S.;
Alvarez-Garcia J.; Lo Bianco G.; Traquair H.; Guerrero-Pinedo F.A.;
Oleynick C.; Meyre P.B.; Mendez-Zurita F.; Chiarella-Redfern H.; Marcucci
M.; Donati F.; Gonzalez-Osuna A.; Minervini F.; Moreno Weidmann Z.;
Guerra-Ramos J.M.; Dion G.; Ramos-Pachon A.; Borges F.K.; de Sa
Boasquevisque D.; Mosconi M.G.; Amarenco P.; Mitchell L.B.; Wyse G.; Cheng
D.; McAlister F.A.; Wells G.A.; Baskaran G.; Burns A.T.; Gennaccaro J.;
Howe R.; Mastrangelo L.; Pettit S.; Popovic M.; Shahbaz S.; Tosh M.;
Zucchetto S.J.; Heenan L.; Lee S.F.; Hoetzenecker K.; Schweiger T.;
Reiterer C.; Zotti O.; Bsuchner P.; Hochreiter B.; Taschner A.;
Adamowitsch N.; Horvath K.; Hantakova N.; Bidgoli J.; Huybrechts I.;
Cappeliez S.; Neary J.D.; Finley C.; Agzarian J.; Hanna W.; Abdulrahman
M.; Lawrence K.; Gregus K.; Quraishi F.; Wikkerink S.; Wallace C.; Prine
M.; Gregus E.; Hare J.; Lombardo K.; Fezia B.; Columbus T.; Rushton J.;
Reid K.; Parlow J.; Chung W.; Karizhenskaia M.; Malik A.; Tanzola R.;
Giles A.; McLean S.R.; McGuire A.; Lohser J.; Lim S.; Grey R.; Yee J.;
Grant K.; Lee A.L.; Choi J.J.; Dewar L.R.; Durkin C.; Schisler T.; Hecht
P.; Hughes B.; Liu R.; Tan L.; Gowing S.; Buduhan G.; Enns S.; Poole E.;
Graham K.; Dubik N.; Chin A.; Maziak D.E.; Seely A.J.; Gilbert S.;
Villeneuve P.J.; Sundaresan S.; Gingrich M.; Fazekas A.; Bucciero K.;
Malthaner R.A.; Lewis D.; Fortin D.; Qiabi M.; Nayak R.; Plourde M.M.;
Haider T.; Murphy R.; Sellers D.; Donahoe L.; Lefebvre M.; Lanthier L.; Ko
M.A.; Parente D.; Cheung V.; Schieman C.; Bessissow A.; Wong R.H.; Joynt
G.M.; Lam C.K.; Lau R.W.; Wan I.Y.; Underwood M.J.; Wu W.K.; Wong W.T.;
Choi G.Y.; Lee E.; Hui K.Y.; Fung B.; Chan C.S.; Ng F.K.; Thung K.H.;
Castaneda L.C.; Tellez L.J.; Ortiz-Ramirez L.M.; Baiardo-Redaelli M.;
Belletti A.; Dieci E.; Monaco F.; Muriana P.; Nakhnoukh C.; Novellis P.;
Turi S.; Viscardi S.; Veronesi G.; Bongiolatti S.; Salvicchi A.; Gatteschi
L.; Indino R.; Tombelli S.; Ravasin A.; Salimbene O.; Rosboch G.L.;
Balzani E.; Ceraolo E.; Neitzert L.; Brazzi L.; Londero F.; Grossi W.;
Massullo D.; Fiorelli S.; Margaritora S.; Hashim S.A.; Krishnasamy S.; See
W.S.; Nawaz M.A.; Bilal H.; Trujillo Reyes J.C.; Belda Sanchis J.; Planas
Canovas G.; Libreros Nino A.; Parera Ruiz A.; Cladellas Gutierrez E.;
Guarino M.; Urrutia Cuchi G.; Argilaga Nogues M.; Rovira Juan A.;
Medina-Aedo M.; Turro Castillejo M.A.; Gil Sanchez J.M.; Arauz-Sarmiento
I.; Herranz Perez G.; Chavarria Murillo S.; Garcia-Osuna A.;
Rodriguez-Arias A.; Berga Garrote N.; Martin Grande A.; Parise Roux D.;
Gajate Martin L.; De Pablo Pajares A.; Candela Toha A.M.; Moreno Mata N.;
Munoz Molina G.; Caballero Silva U.; Cabanero A.; Fra Fernandez S.;
Cavestany Garcia-Matres C.; Simon L.; Montenegro C.; Pozo S.;
Gonzalez-Tallada A.; Gonzalez Suarez S.; Ribas Ball M.; De Nadal Clanchet
M.; Perez Velez J.; Sanchez-Pedrosa G.; Duque P.; Gonzalez G.; Huerta L.;
Rodriguez L.; Garutti I.; Ruiz-Villa L.; Marti-Ejarque M.D.M.; Gili-Bueno
M.; Maddio Vieyra R.M.; Fibla J.J.; Duran N.; de Temple Pla M.;
Rodriguez-Fuster A.; Bermejo-Martinez S.; Carraminana A.; Opitz I.;
Etienne H.; Cata J.P.; Rajaram R.; Corrales G.; Vaporciyan A.; Mehran R.;
Sepesi B.; Walsh G.; Rice D.; Cukierman D.S.; Swisher S.; Marchant B.E.;
Harris L.C.; Cusson B.D.; Miller S.A.; Ayad S.; Araujo J.; Marquez-Roa L.;
Hofstra R.L.; Wudel L.J.; Minear S.C.; Teixeira C.; Pimentel M.; Popoff
A.M.; Marsack K.; Meehan S.; Chen T.H.; Essandoh M.; Poppers J.S.
Institution
(Conen, Ke Wang, McIntyre, Wells, Ofori, Vincent, Xu, Li, Eikelboom,
Jolly, Healey, Devereaux) Population Health Research Institute, Hamilton,
ON, Canada
(Conen, Ke Wang, McIntyre, Tandon, Ofori, Xu, Eikelboom, Jolly, Healey,
Devereaux) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Conen, McIntyre, Jolly, Devereaux) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain
(Popova) Centro Cochrane Iberoamericano, Barcelona, Spain
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, Shatin, Hong Kong
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) School of Medicine, Vita-Salute University San Raffaele, Milan,
Italy
(Cata, Guerra-Londono) Department of Anesthesiology and Perioperative
Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Reimer) Department of Anesthesiology, Queen's University, Kingston Health
Sciences Centre, Kingston, ON, Canada
(McLean) Vancouver Acute Department of Anesthesia and Perioperative
Medicine, Vancouver General Hospital, Vancouver, BC, Canada
(Srinathan, Kidane) Department of Surgery, University of Manitoba,
Winnipeg, MB, Canada
(Reyes, Martinez-Tellez) Department of Thoracic Surgery, Hospital de la
Santa Creu i Sant Pau, Barcelona, Spain
(Grande, Roux) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Vall d'Hebron Hospital
Universitari, Barcelona, Spain
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Voltolini) Thoracic Surgery Unit, University Hospital Careggi, Florence,
Italy
(Cruz) Service of Anesthesiology and Reanimation, General University
Hospital Gregorio Maranon, Madrid, Spain
(Maziak) Division of Thoracic Surgery, Department of Surgery, The Ottawa
Hospital, University of Ottawa, Ottawa, ON, Canada
(Gutierrez-Soriano) Anesthesiology Department, Anesthesiology Research
Group, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
(DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, The
Chinese University of Hong Kong, Hong Kong Special Administrative Region,
Hong Kong
(McGuire) Division of Thoracic Surgery, Vancouver General Hospital,
Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Background: Higher levels of inflammatory biomarkers are associated with
an increased risk of perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery (MINS). Colchicine is an
anti-inflammatory drug that might reduce the incidence of these
complications. <br/>Method(s): COP-AF was a randomised trial conducted at
45 sites in 11 countries. Patients aged 55 years or older and undergoing
major non-cardiac thoracic surgery were randomly assigned (1:1) to receive
oral colchicine 0.5 mg twice daily or matching placebo, starting within 4
h before surgery and continuing for 10 days. Randomisation was done with
use of a computerised, web-based system, and was stratified by centre.
Health-care providers, patients, data collectors, and adjudicators were
masked to treatment assignment. The coprimary outcomes were clinically
important perioperative atrial fibrillation and MINS during 14 days of
follow-up. The main safety outcomes were a composite of sepsis or
infection, and non-infectious diarrhoea. The intention-to-treat principle
was used for all analyses. This trial is registered with
ClinicalTrials.gov, NCT03310125. <br/>Finding(s): Between Feb 14, 2018,
and June 27, 2023, we enrolled 3209 patients (mean age 68 years [SD 7],
1656 [51.6%] male). Clinically important atrial fibrillation occurred in
103 (6.4%) of 1608 patients assigned to colchicine, and 120 (7.5%) of 1601
patients assigned to placebo (hazard ratio [HR] 0.85, 95% CI 0.65 to 1.10;
absolute risk reduction [ARR] 1.1%, 95% CI -0.7 to 2.8; p=0.22). MINS
occurred in 295 (18.3%) patients assigned to colchicine and 325 (20.3%)
patients assigned to placebo (HR 0.89, 0.76 to 1.05; ARR 2.0%, -0.8 to
4.7; p=0.16). The composite outcome of sepsis or infection occurred in 103
(6.4%) patients in the colchicine group and 83 (5.2%) patients in the
placebo group (HR 1.24, 0.93-1.66). Non-infectious diarrhoea was more
common in the colchicine group (134 [8.3%] events) than the placebo group
(38 [2.4%]; HR 3.64, 2.54-5.22). <br/>Interpretation(s): In patients
undergoing major non-cardiac thoracic surgery, administration of
colchicine did not significantly reduce the incidence of clinically
important atrial fibrillation or MINS but increased the risk of mostly
benign non-infectious diarrhoea. <br/>Funding(s): Canadian Institutes of
Health Research, Accelerating Clinical Trials Consortium, Innovation Fund
of the Alternative Funding Plan for the Academic Health Sciences Centres
of Ontario, Population Health Research Institute, Hamilton Health
Sciences, Division of Cardiology at McMaster University, Canada; Hanela
Foundation, Switzerland; and General Research Fund, Research Grants
Council, Hong Kong.<br/>Copyright &#xa9; 2023 Elsevier Ltd

<36>
Accession Number
2032693622
Title
Safety and efficacy of long-term sodium channel blocker therapy for early
rhythm control: the EAST-AFNET 4 trial.
Source
Europace. 26(6) (no pagination), 2024. Article Number: euae121. Date of
Publication: 01 Jun 2024.
Author
Rillig A.; Eckardt L.; Borof K.; John Camm A.; Crijns H.J.G.M.; Goette A.;
Breithardt G.; Lemoine M.D.; Metzner A.; Rottner L.; Schotten U.;
Vettorazzi E.; Wegscheider K.; Zapf A.; Heidbuchel H.; Willems S.; Fabritz
L.; Schnabel R.B.; Magnussen C.; Kirchhof P.
Institution
(Rillig, Borof, Lemoine, Metzner, Rottner, Fabritz, Schnabel, Magnussen,
Kirchhof) Department Of Cardiology, University Heart And Vascular Center,
University Medical Center Hamburg-Eppendorf, Martinistrase 52, Hamburg
20246, Germany
(Rillig, Lemoine, Metzner, Rottner, Wegscheider, Fabritz, Schnabel,
Magnussen, Kirchhof) German Center For Cardiovascular Research, Partner
Site Hamburg/Luebeck/Kiel, Germany
(Eckardt, Goette, Breithardt, Wegscheider, Fabritz, Schnabel, Kirchhof)
Atrial Fibrillation Network (AFNET), Mendelstrase 11, Munster 48149,
Germany
(Eckardt, Breithardt) Department Of Cardiology II-Electrophysiology,
University Hospital Munster, Munster, Germany
(John Camm) Cardiology Clinical Academic Group, Molecular And Clinical
Sciences Research Institute, St. George s University Of London, London,
United Kingdom
(Crijns) Department Of Cardiology, Maastricht University Medical Center,
Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
(Goette) St. Vincenz Hospital, Paderborn, Germany
(Goette) Working Group Of Molecular Electrophysiology, University Hospital
Magdeburg, Magdeburg, Germany
(Schotten) Department Of Physiology, Maastricht University, Maastricht,
Netherlands
(Vettorazzi, Wegscheider, Zapf) Institute Of Medical Biometry And
Epidemiology, University Medical Center Hamburg Eppendorf, Hamburg,
Germany
(Heidbuchel) Faculty Of Medicine And Health Sciences, Department Of
Cardiology, Antwerp University Hospital, University Of Antwerp, Antwerp,
Belgium
(Heidbuchel) Faculty Of Medicine And Health Sciences, Cardiovascular
Research, Gencor, Antwerp University, Antwerp, Belgium
(Heidbuchel) Faculty Of Medicine And Life Sciences, Hasselt University,
Hasselt, Belgium
(Willems) Asklepios Klinik St. Georg, Klinik Fur Kardiologie Und
Internistische Intensivmedizin, Hamburg, Germany
(Fabritz) University Center Of Cardiovascular Science, University Heart
And Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Fabritz, Kirchhof) Institute Of Cardiovascular Sciences, University Of
Birmingham, Birmingham, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Clinical concerns exist about the potential proarrhythmic effects of
the sodium channel blockers (SCBs) flecainide and propafenone in patients
with cardiovascular disease. Sodium channel blockers were used to deliver
early rhythm control (ERC) therapy in EAST-AFNET 4. <br/>Methods and
Results: We analysed the primary safety outcome (death, stroke, or serious
adverse events related to rhythm control therapy) and primary efficacy
outcome (cardiovascular death, stroke, and hospitalization for worsening
of heart failure (HF) or acute coronary syndrome) during SCB intake for
patients with ERC (n = 1395) in EAST-AFNET 4. The protocol discouraged
flecainide and propafenone in patients with reduced left ventricular
ejection fraction and suggested stopping therapy upon QRS prolongation
>25% on therapy. Flecainide or propafenone was given to 689 patients [age
69 (8) years; CHA2DS2-VASc 3.2 (1); 177 with HF; 41 with prior myocardial
infarction, coronary artery bypass graft, or percutaneous coronary
intervention; 26 with left ventricular hypertrophy >15 mm; median therapy
duration 1153 [237, 1828] days]. The primary efficacy outcome occurred
less often in patients treated with SCB [3/100 (99/3316) patient-years]
than in patients who never received SCB [SCBnever 4.9/100 (150/3083)
patient-years, P < 0.001]. There were numerically fewer primary safety
outcomes in patients receiving SCB [2.9/100 (96/3359) patient-years] than
in SCBnever patients [4.2/100 (135/3220) patient-years, adjusted P =
0.015]. Sinus rhythm at 2 years was similar between groups [SCB 537/610
(88); SCBnever 472/579 (82)]. <br/>Conclusion(s): Long-term therapy with
flecainide or propafenone appeared to be safe in the EAST-AFNET 4 trial to
deliver effective ERC therapy, including in selected patients with stable
cardiovascular disease such as coronary artery disease and stable
HF.<br/>Copyright &#xa9; 2024 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology.

<37>
[Use Link to view the full text]
Accession Number
2032693421
Title
Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in
Children Undergoing Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Pediatric Critical Care Medicine. 25(6) (pp e291-e302), 2024. Date of
Publication: 01 Jun 2024.
Author
Ulrich E.H.; Bedi P.K.; Alobaidi R.; Morgan C.J.; Paulden M.; Zappitelli
M.; Bagshaw S.M.
Institution
(Ulrich, Morgan) Division of Pediatric Nephrology, Department of
Pediatrics, University of Alberta, Edmonton, AB, Canada
(Bedi) Department of Pediatrics, University of Manitoba, Winnipeg, MB,
Canada
(Alobaidi) Division of Pediatric Critical Care, Department of Pediatrics,
University of Alberta, Edmonton, AB, Canada
(Paulden) Health Economics, School of Public Health, University of
Alberta, Edmonton, AB, Canada
(Zappitelli) Division of Pediatric Nephrology, Department of Pediatrics,
University of Toronto, Toronto, ON, Canada
(Bagshaw) Department of Critical Care Medicine, Faculty of Medicine and
Dentistry, University of Alberta and Alberta Health Services, Edmonton,
AB, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: The objective of this Prospective Register of Systematic
Reviews (CRD42022384192) registered systematic review and meta-analysis
was to determine whether prophylactic peritoneal dialysis (PD) catheter
insertion at the time of pediatric cardiac surgery is associated with
improved short-term outcomes. DATA SOURCES: Databases search of the
MEDLINE, EMBASE, CINAHL, and Cochrane Library completed in April 2021 and
updated October 2023. STUDY SELECTION: Two reviewers independently
completed study selection, data extraction, and bias assessment. Inclusion
criteria were randomized controlled trials (RCTs) and observational
studies of children (<= 18 yr) undergoing cardiac surgery with
cardiopulmonary bypass. We evaluated use of prophylactic PD catheter
versus not. DATA EXTRACTION: The primary outcome was in-hospital
mortality, as well as secondary short-term outcomes. Pooled random-effect
meta-analysis odds ratio with 95% CI are reported. DATA SYNTHESIS:
Seventeen studies met inclusion criteria, including four RCTs. The non-PD
catheter group received supportive care that included diuretics and late
placement of PD catheters in the ICU. Most study populations included
children younger than 1 year and weight less than 10 kg. Cardiac surgery
was most commonly used for arterial switch operation. In-hospital
mortality was reported in 13 studies; pooled analysis showed no
association between prophylactic PD catheter placement and in-hospital
mortality. There were mixed results for ICU length of stay and time to
negative fluid balance, with some studies showing shortened duration
associated with use of prophylactic PD catheter insertion and others
showing no difference. Overall, the studies had high risk for bias, mainly
due to small sample size and lack of generalizability. <br/>CONCLUSION(S):
In this meta-analysis, we have failed to demonstrate an association
between prophylactic PD catheter insertion in children and infants
undergoing cardiac surgery and reduced in-hospital mortality. Other
relevant short-term outcomes, including markers of fluid overload, require
further study.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<38>
Accession Number
2031489671
Title
Outcomes of Vasopressin-Receptor Agonists Versus Norepinephrine in Adults
With Perioperative Hypotension: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(7) (pp 1577-1586),
2024. Date of Publication: July 2024.
Author
Heybati K.; Xie G.; Ellythy L.; Poudel K.; Deng J.; Zhou F.; Chelf C.J.;
Ripoll J.G.; Ramakrishna H.
Institution
(Heybati, Xie, Ellythy, Poudel) Mayo Clinic Alix School of Medicine, Mayo
Clinic, Rochester, MN, United States
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Chelf) Mayo Clinic Libraries, Rochester, MN, United States
(Ripoll, Ramakrishna) Department of Anesthesiology and Perioperative
Medicine, Mayo Clinic, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Consensus statements recommend the use of norepinephrine and/or
vasopressin for hypotension in cardiac surgery. However, there is a
paucity of data among other surgical subgroups and vasopressin analogs.
Therefore, the authors conducted a systematic review of randomized
controlled trials (RCTs) to compare vasopressin-receptor agonists with
norepinephrine for hypotension among those undergoing surgery with general
anesthesia. This review was registered prospectively (CRD42022316328).
Literature searches were conducted by a medical librarian to November 28,
2023, across MEDLINE, EMBASE, CENTRAL, and Web of Science. The authors
included RCTs enrolling adults (>=18 years of age) undergoing any surgery
under general anesthesia who developed perioperative hypotension and
comparing vasopressin receptor agonists with norepinephrine. The risk of
bias was assessed by the Cochrane risk of bias tool for randomized trials
(RoB-2). Thirteen (N = 719) RCTs were included, of which 8 (n = 585)
enrolled patients undergoing cardiac surgery. Five trials compared
norepinephrine with vasopressin, 4 trials with terlipressin, 1 trial with
ornipressin, and the other 3 trials used vasopressin as adjuvant therapy.
There was no significant difference in all-cause mortality. Among patients
with vasoplegic shock after cardiac surgery, vasopressin was associated
with significantly lower intensive care unit (N = 385; 2 trials; mean
100.8 v 175.2 hours, p < 0.005; median 120 [IQR 96-168] v 144 [96-216]
hours, p = 0.007) and hospital lengths of stay, as well as fewer cases of
acute kidney injury and atrial fibrillation compared with norepinephrine.
One trial also found that terlipressin was associated with a significantly
lower incidence of acute kidney injury versus norepinephrine overall.
Vasopressin and norepinephrine restored mean arterial blood pressure with
no significant differences; however, the use of vasopressin with
norepinephrine was associated with significantly higher mean arterial
blood pressure versus norepinephrine alone. Further high-quality trials
are needed to determine pooled treatment effects, especially among
noncardiac surgical patients and those treated with vasopressin
analogs.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<39>
Accession Number
2030143570
Title
Hemolysis during open heart surgery in patients with hereditary
spherocytosis - systematic review of the literature and case study.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 54.
Date of Publication: December 2024.
Author
Mendrala K.; Czober T.; Darocha T.; Hudziak D.; Podsiadlo P.; Kosinski S.;
Jagoda B.; Gocol R.
Institution
(Mendrala, Czober, Darocha, Jagoda) Department of Anaesthesiology and
Intensive Care, Medical University of Silesia, Katowice, Poland
(Hudziak, Gocol) Department of Cardiac Surgery, Upper-Silesian Medical
Centre, Medical University of Silesia, Katowice, Poland
(Podsiadlo) Department of Emergency Medicine, Jan Kochanowski University,
Kielce, Poland
(Kosinski) Department of Intensive Interdisciplinary Therapy, Jagiellonian
University Collegium Medicum, Krakow, Poland
Publisher
BioMed Central Ltd
Abstract
Background: Due to the distinctive nature of cardiac surgery, patients
suffering from hereditary spherocytosis (HS) are potentially at a high
risk of perioperative complications resulting from hemolysis. Despite
being the most prevalent cause of hereditary chronic hemolysis, the
standards of surgical management are based solely on expert opinion.
<br/>Objective(s): We analyze the risk of hemolysis in HS patients after
cardiac surgery based on a systematic review of the literature. We also
describe a case of a patient with hereditary spherocytosis who underwent
aortic valve repair. <br/>Method(s): This systematic review was registered
in the PROSPERO international prospective register of systematic reviews
(CRD42023417666) and included records from Embase, MEDLINE, Web of
Science, and Google Scholar databases. The case study investigates a
38-year-old patient who underwent surgery for an aortic valve defect in
mid-2022. <br/>Result(s): Of the 787 search results, 21 studies describing
23 cases of HS undergoing cardiac surgery were included in the final
analysis. Hemolysis was diagnosed in five patients (one coronary artery
bypass graft surgery, two aortic valve bioprosthesis, one ventricular
septal defect closure, and one mitral valve plasty). None of the patients
died in the perioperative period. Also, no significant clinical hemolysis
was observed in our patient during the perioperative period.
<br/>Conclusion(s): The literature data show that hemolysis is not common
in patients with HS undergoing various cardiac surgery techniques. The
typical management of a patient with mild/moderate HS does not appear to
increase the risk of significant clinical hemolysis. Commonly accepted
beliefs about factors inducing hemolysis during cardiac surgery may not be
fully justified and require further investigation.<br/>Copyright &#xa9;
The Author(s) 2024.

<40>
Accession Number
2032774088
Title
Antiplatelet therapy after coronary artery bypass surgery: five year
follow-up of randomised DACAB trial.
Source
BMJ. (no pagination), 2024. Date of Publication: 2024.
Author
Zhu Y.; Zhang W.; Dimagli A.; Han L.; Cheng Z.; Mei J.; Chen X.; Wang X.;
Zhou Y.; Xue Q.; Hu J.; Tang M.; Wang R.; Song Y.; Kang L.; Redfors B.;
Gaudino M.; Zhao Q.
Institution
(Zhu, Zhou, Kang, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital Shanghai Jiao Tong University School of Medicine, Shanghai
200025, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai 200032, China
(Dimagli, Gaudino) Department of Cardio-thoracic Surgery, Weill Cornell
Medicine, New York, NY 10065, United States
(Han, Xue) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Naval Medical University (Shanghai Changhai Hospital),
Shanghai 200433, China
(Cheng, Hu) Department of Cardiac Surgery, Heart Centre of Henan
Provincial People's Hospital, Central China Fuwai Hospital of Zhengzhou
University, Zhengzhou 451464, China
(Mei, Tang) Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai
Jiao Tong University School of Medicine, Shanghai 200092, China
(Chen, Wang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing Medical University, Nanjing 210006, China
(Wang, Song) Department of Cardiovascular Surgery, Jiangsu Province
Hospital, Nanjing 210029, China
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg 41345, Sweden
Publisher
BMJ Publishing Group
Abstract
OBJECTIVE To assess the effect of different antiplatelet strategies on
clinical outcomes after coronary artery bypass grafting. DESIGN Five year
follow-up of randomised Different Antiplatelet Therapy Strategy After
Coronary Artery Bypass Grafting (DACAB) trial. SETTING Six tertiary
hospitals in China; enrolment between July 2014 and November 2015;
completion of five year follow-up from August 2019 to June 2021.
PARTICIPANTS 500 patients aged 18-80 years (including 91 (18.2%) women)
who had elective coronary artery bypass grafting surgery and completed the
DACAB trial. INTERVENTIONS Patients were randomised 1:1:1 to ticagrelor 90
mg twice daily plus aspirin 100 mg once daily (dual antiplatelet therapy;
n=168), ticagrelor monotherapy 90 mg twice daily (n=166), or aspirin
monotherapy 100 mg once daily (n=166) for one year after surgery. After
the first year, antiplatelet therapy was prescribed according to standard
of care by treating physicians. MAIN OUTCOME MEASURES The primary outcome
was major adverse cardiovascular events (a composite of all cause death,
myocardial infarction, stroke, and coronary revascularisation), analysed
using the intention-to-treat principle. Time-to-event analysis was used to
compare the risk between treatment groups. Multiple post hoc sensitivity
analyses examined the robustness of the findings. RESULTS Follow-up at
five years for major adverse cardiovascular events was completed for 477
(95.4%) of 500 patients; 148 patients had major adverse cardiovascular
events, including 39 in the dual antiplatelet therapy group, 54 in the
ticagrelor monotherapy group, and 55 in the aspirin monotherapy group.
Risk of major adverse cardiovascular events at five years was
significantly lower with dual antiplatelet therapy versus aspirin
monotherapy (22.6% v 29.9%; hazard ratio 0.65, 95% confidence interval
0.43 to 0.99; P=0.04) and versus ticagrelor monotherapy (22.6% v 32.9%;
0.66, 0.44 to 1.00; P=0.05). Results were consistent in all sensitivity
analyses. CONCLUSIONS Treatment with ticagrelor dual antiplatelet therapy
for one year after surgery reduced the risk of major adverse
cardiovascular events at five years after coronary artery bypass grafting
compared with aspirin monotherapy or ticagrelor monotherapy.<br/>Copyright
&#xa9; 2024 BMJ Publishing Group. All rights reserved.

<41>
Accession Number
2030181468
Title
Effects of Perioperative Zinc Supplementation on Copper Circulating Levels
and Expression of Metallothionein and Copper Antioxidant Chaperone-1 in
Leukocytes in Patients Undergoing CABG Surgery.
Source
Biological Trace Element Research. (no pagination), 2024. Date of
Publication: 2024.
Author
Makiabadi E.; Nasrollahzadeh J.; Nakhaeizadeh R.; Shahparvari M.R.;
Roohelhami E.
Institution
(Makiabadi, Nasrollahzadeh, Shahparvari, Roohelhami) Department of
Clinical Nutrition & amp; Dietetics, Faculty of Nutrition Sciences and
Food Technology, National Nutrition and Food Technology Research
Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Nakhaeizadeh) Department of Surgery, School of Medicine, Shafa Hospital,
Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of
Publisher
Springer
Abstract
The use of zinc supplement may have a negative effect on copper status.
The objective of this study was to evaluate the effect of zinc and vitamin
E supplementation on copper and zinc biomarkers in patients undergoing
coronary artery bypass graft (CABG) surgery. The study was an add-on
project to a previously published randomized controlled trial
(NCT05402826) on patients undergoing CABG surgery. Patients in the
zinc-vitamin E group (n = 40) received oral zinc (120 mg) and vitamin E
(1200 international units) 1 day before surgery, followed by 30 mg of zinc
and 200 units of vitamin E per day until 21 days after surgery, while
those in the control group (n = 38) received placebo. Plasma levels of
copper, ceruloplasmin, superoxide dismutase (SOD) activity, as well as
leukocyte gene expression of metallothionein 2A (MT2A) and antioxidant
protein 1 (ATOX1), were determined 3 and 21 days after surgery. The plasma
copper level in the zinc-vitamin E group was significantly lower than the
placebo group on the 3rd postoperative day, but no significant
between-group differences were observed on day 21. Plasma ceruloplasmin
concentration and SOD activity were not different. Relative mRNA
expression of leukocyte MT2A was increased at both times (days 3 and 21 in
the zinc-vitamin E group compared to placebo, but ATOX1 expression was not
affected. Although the plasma copper level was transiently decreased early
after surgery in the zinc-vitamin E group, considering the lack of change
in other copper biomarkers, it seems that the use of zinc supplements at
the dose used in the present study does not have a significant negative
effect on the role of intracellular copper.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<42>
Accession Number
2030181219
Title
Cardioprotection with Intralipid During Coronary Artery Bypass Grafting
Surgery on Cardiopulmonary Bypass: A Randomized Clinical Trial.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Hadebe N.; Cour M.; Imamdin A.; Petersen T.; Pennel T.; Scherman J.;
Snowball J.; Ntsekhe M.; Zilla P.; Swanevelder J.; Lecour S.
Institution
(Hadebe, Cour, Imamdin, Petersen, Snowball, Lecour) Cardioprotection
Group, Faculty of Health Sciences, Cape Heart Institute, University of
Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
(Hadebe, Swanevelder) Department of Anaesthesia, Faculty of Health
Sciences, University of Cape Town, Cape Town, South Africa
(Pennel, Scherman, Zilla) Chris Barnard Division of Cardiothoracic
Surgery, University of Cape Town, Cape Town, South Africa
(Ntsekhe) Division of Cardiology, Faculty of Health Sciences, University
of Cape Town, Cape Town, South Africa
Publisher
Springer
Abstract
Purpose: Coronary artery bypass grafting (CABG) on cardiopulmonary bypass
(CPB) is associated with myocardial ischemia-reperfusion injury (IRI),
which may limit the benefit of the surgery. Both experimental and clinical
studies suggest that Intralipid, a lipid emulsion commonly used for
parenteral nutrition, can limit myocardial IRI. We therefore aimed to
investigate whether Intralipid administered at reperfusion can reduce
myocardial IRI in patients undergoing CABG on CPB. <br/>Method(s): We
conducted a randomized, double-blind, pilot trial in which 29 adult
patients scheduled for CABG were randomly assigned (on a 1:1 basis) to
receive either 1.5 ml/kg Intralipid 20% or Ringer's Lactate 3 min before
aortic cross unclamping. The primary endpoint was the 72-h area under the
curve (AUC) for troponin I. <br/>Result(s): Of the 29 patients randomized,
26 were included in the study (two withdrew consent and one was excluded
before surgery). The 72-h AUC for troponin I did not significantly differ
between the control and Intralipid group (546437 +/- 205518 versus 487561
+/- 115724 arbitrary units, respectively; P = 0.804). Other outcomes
(including 72-h AUC for CK-MB, C-reactive protein, need for
defibrillation, time to extubation, length of ICU and hospital stay, and
serious adverse events) were similar between the two groups.
<br/>Conclusion(s): In patients undergoing CABG on CPB, Intralipid did not
limit myocardial IRI compared to placebo. Trial Registration:
ClinicalTrials.gov Identifier: NCT02807727 (registration date: 16 June
2016).<br/>Copyright &#xa9; The Author(s) 2024.

<43>
Accession Number
2032789196
Title
Healthcare Resource Utilization Comparison of Balloon-Expandable Valve
Versus Self-Expandable Valve for Transcatheter Aortic Valve Replacement in
China.
Source
Value in Health. Conference: ISPOR 2024. Atlanta United States. 27(6
Supplement) (pp S60), 2024. Date of Publication: June 2024.
Author
Tan B.; Luo C.; Lv K.; Xuan J.; Ma L.
Institution
(Tan, Luo, Lv, Xuan) Health Economic Research Institute, School of
Pharmacy, Sun Yat-Sen University, Guangdong, Guangzhou, China
(Ma) The First Affiliated Hospital, Sun Yat-sen University, GuangDong,
Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Objectives: The balloon-expandable (BE) valve, which is used to treat
aortic stenosis (AS), is an approved implant for transcatheter aortic
valve replacement (TAVR), showing a clinical advantage over the
self-expandable (SE) valve in previous randomized clinical trials. This
study aimed to compare the healthcare resources use for these two types of
valves, investigating the economic advantages associated with the BE
valve. <br/>Method(s): All data were retrospectively derived from a
tertiary hospital in Guangzhou, China. Patients who had AS and received
TAVR, were identified between July 1, 2020, and December 31, 2022. The
baseline characteristics, length of stay and hospitalization expenses of
the patients were analyzed. <br/>Result(s): Study population included 69
patients implanted with BE valves (n=18) and SE valves (n=51). The
baseline characteristics, including age, gender, NYHA functional
classification, were evenly distributed between two patient groups. The
total expenses associated with the BE valve were substantially higher than
those of the SE valve, driven by the high cost of the surgery and
materials. However, it might be offset by the reduction in the length of
stay and the corresponding healthcare resource savings. Patients in the BE
valve group had a notably shorter length of stay compared to the SE valve
group (12.78 vs 16.73, p=0.03), including a significantly decreased ICU
length of stay (1.78 vs 3.61, p=0.02) and a shorter length of
postoperative stay (5.44 vs 8.76, p<0.01). Furthermore, compared with SE
group, the BE group demonstrated notable cost savings in medicine
expenses, treatment expenses, laboratory costs and nursing fees, by
3,586.26 CNY, 4,102.18 CNY, 2,564.34 CNY, and 606.30 CNY, respectively.
<br/>Conclusion(s): The real-world evidence indicates the potential
economic advantages of the BE valve. Due to the limited sample size of the
two study groups, our findings should be validated through a multicentre,
large-scale study.<br/>Copyright &#xa9; 2024

<44>
Accession Number
2032788288
Title
EE200 An Economic Systematic Literature Review for Hypertrophic
Obstructive Cardiomyopathy.
Source
Value in Health. Conference: ISPOR 2024. Atlanta United States. 27(6
Supplement) (pp S94), 2024. Date of Publication: June 2024.
Author
Krause T.; Slater D.; Boulton E.; Luedke H.; Hurst M.; Maksabedian H.E.;
Pashley A.
Institution
(Krause) Bristol Myers Squibb, LON, LONDON, United Kingdom
(Slater, Boulton, Luedke) Costello Medical, Cambridgeshire, Cambridge,
United Kingdom
(Hurst) Bristol Myers Squibb, LON, Uxbridge, United Kingdom
(Maksabedian) Bristol Myers Squibb, Princeton, NJ, United States
(Pashley) Costello Medical, CAM, Cambridge, United Kingdom
Publisher
Elsevier Ltd
Abstract
Objectives: Obstructive hypertrophic cardiomyopathy (HCM) is a chronic,
progressive disease characterized by left ventricular (LV) hypertrophy and
fibrosis due to sarcomeric dysfunction. A systematic literature review
(SLR) was conducted to identify economic evaluations (EEs), and studies
reporting on health state utility values (HSUVs) and healthcare cost and
resource use (HCRU) data associated with obstructive HCM. <br/>Method(s):
This SLR was conducted in accordance with Cochrane Collaboration guidance.
Literature searches were performed across MEDLINE, Embase, EconLit,
PsycINFO and the Health Technology Assessment (HTA) databases from
database inception to December 2021 and updated in July 2023. Relevant
congress proceedings from 2019-2023, HTA/economic websites and SLR and HTA
bibliographies were manually searched. Record screening was performed by 2
independent researchers, using the predefined inclusion and exclusion
criteria with any disagreements resolved by a third reviewer.
<br/>Result(s): 954 and 403 unique records were identified from literature
searches up to December 2021 and the July 2023 update following
deduplication, respectively, which were screened against pre-determined
eligibility criteria. Including manual supplementary searches, a total of
8 unique EEs, 2 HSUV studies and 57 HCRU studies were included in this
SLR. All 8 EEs assessed mavacamten, a cardiac myosin inhibitor. One HSUV
study elicited EQ-5D data from a randomized trial of mavacamten; the
remaining elicited EQ-5D pre- and post-septal myectomy. Identified HCRU
data were heterogeneous, most commonly reporting on medication use,
surgical procedures, hospital stay and readmissions, and permanent
pacemaker implantation. No indirect HCRU data were identified.
<br/>Conclusion(s): The SLR identified a substantial volume of HCRU
evidence describing the economic burden of obstructive HCM on different
healthcare systems, although data on indirect impacts are needed to
characterize the societal impact of the condition. This contrasts with the
paucity of cost-effectiveness and HSUV evidence identified, which reflects
the historic lack of innovation in treatments for this
condition.<br/>Copyright &#xa9; 2024

<45>
Accession Number
2032781721
Title
Effect of empagliflozin on all-cause hospitalization in EMPA-KIDNEY.
Source
Metabolism: Clinical and Experimental. Conference: 21st World Congress
Insulin Resistance, Diabetes, and Cardiovascular Disease. Universal
Hollywood Dr, Universal City, Los Angeles United States. 153(Supplement)
(no pagination), 2024. Article Number: 155857. Date of Publication: June
2024.
Author
Uster A.; Desai N.; Navaneethan S.; Pfarr E.; Mazo A.R.
Institution
(Uster, Pfarr, Mazo) Boehringer Ingelheim International GmbH,
Ingelheim-am-Rhein, Germany
(Desai) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, United States
(Navaneethan) Selzman Institute for Kidney Health, Section of Nephrology,
Department of Medicine, Baylor College of Medicine, Houston, TX, United
States
Publisher
W.B. Saunders
Abstract
Background: Chronic kidney disease (CKD) increases the risk of
hospitalization. In the randomized, phase III, EMPA-KIDNEY trial,
empagliflozin significantly reduced the risk of all-cause hospitalizations
([ACH] first and recurrent) vs placebo. This post-hoc analysis of the
EMPA-KIDNEY trial examines the burden of ACH in CKD and the effects of
empagliflozin on ACH. Methods Participants with CKD (n=6609) were
randomized to empagliflozin 10 mg or placebo. Reasons for hospitalizations
were derived from adverse events (AEs) leading to hospitalization,
assessed by system organ class (SOC). Results 1995 participants had >=1
ACH (1895 ACH in placebo and 1611 in the empagliflozin 10 mg groups). The
mortality rate over the trial period in participants with >=1
hospitalization was 25% and risk of death was ~10 times higher vs those
without (hazard ratio [HR] 9.53; 95% CI 7.18, 12.64; p <0.0001). Most
common reasons for ACH were infections and infestations, surgical and
medical procedures, cardiac disorders, renal and urinary disorders, and
investigations. Risk of ACH was significantly reduced for empagliflozin vs
placebo (HR 0.86, 99.03% CI 0.75, 0.98, p=0.0025). This was consistent
regardless of baseline diabetes status, estimated glomerular filtration
rate or UACR. Mean cumulative incidence of ACH in empagliflozin and
placebo groups diverged shortly after randomization and continued to
separate over time. Risk of hospital admissions attributed to
cardiovascular (CV), renal or metabolic conditions was significantly lower
with empagliflozin vs placebo (p<0.05). Conclusions Treatment with
empagliflozin significantly reduced risk of all-cause hospitalizations,
including those attributed to CV, renal, or metabolic
conditions.<br/>Copyright &#xa9; 2024

<46>
Accession Number
644504095
Title
Impact of neuromuscular block on myocardial injury after non-cardiac
surgery (MINS) incidence in the early postoperative stage of older
patients undergoing laparoscopic colorectal cancer resection: a randomized
controlled study.
Source
BMC geriatrics. 24(1) (pp 509), 2024. Date of Publication: 12 Jun 2024.
Author
An Y.; Wang T.; Li L.; Li Z.; Liang C.; Wang P.; Jia X.; Song H.; Zhao L.
Institution
(An, Wang, Li, Li, Liang, Wang, Jia, Song, Zhao) Department of
Anesthesiology, Xuanwu Hospital, Capital Medical University, 45 Changchun
Street, Xicheng District, Beijing 100053, China
Abstract
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) is a common
and serious complication in older patients. This study investigates the
impact of neuromuscular block on the MINS incidence and other
cardiovascular complications in the early postoperative stage of older
patients undergoing laparoscopic colorectal cancer resection.
<br/>METHOD(S): 70 older patients who underwent laparoscopic colorectal
cancer resection were separated into the deep neuromuscular block group
and moderate neuromuscular block group for 35 cases in each group (n=1:1).
The deep neuromuscular block group maintained train of four (TOF)=0,
post-tetanic count (PTC) 1-2, and the moderate neuromuscular block group
maintained TOF=1-2 during the operation. Sugammadex sodium was used at 2
mg/kg or 4 mg/kg for muscle relaxation antagonism at the end of surgery.
The MINS incidence was the primary outcome and compared with Fisher's
exact test. About the secondary outcomes, the postoperative pain was
analyzed with Man-Whitney U test, the postoperative nausea and vomiting
(PONV) and the incidence of cardiovascular complications were analyzed
with Chi-square test, intraoperative mean artery pressure (MAP) and
cardiac output (CO) ratio to baseline, length of stay and dosage of
anesthetics were compared by two independent samples t-test.
<br/>RESULT(S): MINS was not observed in both groups. The highest
incidence of postoperative cardiovascular complications was lower limbs
deep vein thrombosis (14.3% in deep neuromuscular block group and 8.6% in
moderate neuromuscular group). The numeric rating scale (NRS) score in the
deep neuromuscular block group was lower than the moderate neuromuscular
block group 72 h after surgery (0(1,2) vs 0(1,2), P=0.018). The operation
time in the deep neuromuscular block group was longer (356.7(107.6) vs
294.8 (80.0), min, P=0.008), the dosage of propofol and remifentanil was
less (3.4 (0.7) vs 3.8 (1.0), mg.kg-1.h-1, P=0.043; 0.2 (0.06) vs 0.3
(0.07), mug.kg-1.min-1, P<0.001), and the length of hospital stay was
shorter than the moderate neuromuscular block group (18.4 (4.9) vs 22.0
(8.3), day, P=0.028). The differences of other outcomes were not
statistically significant. <br/>CONCLUSION(S): Maintaining different
degrees of the neuromuscular block under TOF guidance did not change the
MINS incidence within 7 days after surgery in older patients who underwent
laparoscopic colorectal cancer resection. TRIAL REGISTRATION: The present
study was registered in the Chinese Clinical Trial Registry (10/02/2021,
ChiCTR2100043323).<br/>Copyright &#xa9; 2024. The Author(s).

<47>
Accession Number
2032822973
Title
Surgery compared to fibrinolytic therapy for symptomatic left-sided
prosthetic heart valve thrombosis (SAFE-PVT): Rationale and design of a
randomized controlled trial.
Source
Indian Heart Journal. (no pagination), 2024. Date of Publication: 2024.
Author
Devasenapathy N.; Devagourou V.; Hote M.P.; Rajashekar P.; Kidambi B.;
Singal A.; Mantoo M.R.; Soni M.; Purohit G.; Singh S.; Karthikeyan G.
Institution
(Devasenapathy, Soni) The George Institute of Global Health, New Delhi,
India
(Devagourou, Hote, Rajashekar, Kidambi, Singal, Mantoo, Purohit, Singh,
Karthikeyan) Cardiothoracic Sciences Centre, All India Institute of
Medical Sciences, New Delhi, India
(Karthikeyan) Translational Health Science and Technology Institute,
Haryana, Faridabad, India
Publisher
Elsevier B.V.
Abstract
Background: Left-sided mechanical prosthetic heart valve thrombosis (PVT)
occurs because of suboptimal anticoagulation and is common in low-resource
settings. Urgent surgery and fibrinolytic therapy (FT) are the two
treatment options available for this condition. Urgent surgery is a
high-risk procedure but results in successful restoration of valve
function more often and is the treatment of choice in developed countries.
In low-resource countries, FT is used as the default treatment strategy,
though it is associated with lower success rates and a higher rate of
bleeding and embolic complications. There are no randomized trials
comparing the two modalities. <br/>Method(s): We performed a single center
randomized controlled trial comparing urgent surgery (valve replacement or
thrombectomy) with FT (low-dose, slow infusion tissue plasminogen
activator, tPA) in patients with symptomatic left-sided PVT. The primary
outcome was the occurrence of a complete clinical response, defined as
discharge from hospital with completely restored valve function, in the
absence of stroke, major bleeding or non-CNS systemic embolism. Outcome
assessment was done by investigators blinded to treatment allocation. The
principal safety outcome was the occurrence of a composite of in-hospital
death, non-fatal stroke, non-fatal major bleed or non-CNS systemic
embolism. Outcomes will be assessed both in the intention-to-treat, and in
the as-treated population. We will also report outcomes at one year of
follow-up. The trial has completed recruitment. <br/>Conclusion(s): This
is the first randomized trial to compare urgent surgery with FT for the
treatment of left-sided PVT. The results will provide evidence to help
clinicians make treatment choices for these patients. (Clinical trial
registration: CTRI/2017/10/010159).<br/>Copyright &#xa9; 2024
Cardiological Society of India

<48>
Accession Number
2032820129
Title
Outcome-based Risk Assessment of Non-HLA Antibodies in Heart
Transplantation: A Systematic Review.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2024. Date of
Publication: 2024.
Author
Panicker A.J.; Prokop L.J.; Hacke K.; Jaramillo A.; Griffiths L.G.
Institution
(Panicker, Griffiths) Mayo Clinic Graduate School of Biomedical Sciences,
Mayo Clinic, Rochester, Minnesota, United States
(Panicker) Department of Immunology, Mayo Clinic, Rochester, Minnesota,
United States
(Panicker, Griffiths) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, Minnesota, United States
(Prokop) Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, United
States
(Hacke, Jaramillo) Department of Laboratory Medicine and Pathology, Mayo
Clinic, Phoenix, Arizona, United States
(Griffiths) Department of Physiology & Biomedical Engineering, Mayo
Clinic, Rochester, Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Background: Current monitoring after heart transplantation (HT) employs
repeated invasive endomyocardial biopsies (EMB). Although positive EMB
confirms rejection, EMB fails to predict impending, subclinical, or
EMB-negative rejection events. While non-human leukocyte antigen (non-HLA)
antibodies have emerged as important risk factors for antibody-mediated
rejection after HT, their use in clinical risk stratification has been
limited. A systematic review of the role of non-HLA antibodies in
rejection pathologies has the potential to guide efforts to overcome
deficiencies of EMB in rejection monitoring. <br/>Method(s): Databases
were searched to include studies on non-HLA antibodies in HT recipients.
Data collected included the number of patients, type of rejection, non-HLA
antigen studied, association of non-HLA antibodies with rejection, and
evidence for synergistic interaction between non-HLA antibodies and
donor-specific anti-human leukocyte antigen antibody (HLA-DSA) responses.
<br/>Result(s): A total of 56 studies met the inclusion criteria. Strength
of evidence for each non-HLA antibody was evaluated based on the number of
articles and patients in support versus against their role in mediating
rejection. Importantly, despite previous intense focus on the role of
anti-major histocompatibility complex class I chain-related gene A (MICA)
and anti-angiotensin II type I receptor antibodies (AT1R) in HT rejection,
evidence for their involvement was equivocal. Conversely, the strength of
evidence for other non-HLA antibodies supports that differing rejection
pathologies are driven by differing non-HLA antibodies.
<br/>Conclusion(s): This systematic review underscores the importance of
identifying peri-HT non-HLA antibodies. Current evidence supports the role
of non-HLA antibodies in all forms of HT rejection. Further investigations
are required to define the mechanisms of action of non-HLA antibodies in
HT rejection.<br/>Copyright &#xa9; 2024 International Society for the
Heart and Lung Transplantation

<49>
Accession Number
2032817248
Title
The Impact of Acute Kidney Injury on Chronic Kidney Disease After Cardiac
Surgery: A Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Lindhardt R.B.; Rasmussen S.B.; Riber L.P.; Lassen J.F.; Ravn H.B.
Institution
(Lindhardt, Rasmussen, Ravn) Department of Anesthesiology and Intensive
Care, Odense University Hospital, Odense, Denmark
(Lindhardt, Rasmussen, Riber, Lassen, Ravn) Department of Clinical
Research, Health Faculty, University of Southern Denmark, Odense, Denmark
(Riber) Department of Cardiac, Thoracic and Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Lassen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the impact of acute kidney injury on transition to
chronic kidney disease (CKD) after cardiac surgery and to determine
frequency of incident CKD in these patients. <br/>Design(s): A systematic
review and meta-analysis of observational studies. <br/>Setting(s):
Electronic databases Medline and Embase were systematically searched from
1974 to February 6, 2023. <br/>Participant(s): Eligible studies were
original observational studies on adult cardiac surgery patients, written
in the English language, and with clear kidney disease definitions.
Exclusion criteria were studies with previously transplanted populations,
populations with preoperative kidney impairment, ventricular assist device
procedures, endovascular procedures, a kidney follow-up period of <90
days, and studies not presenting necessary data for effect size
calculations. <br/>Intervention(s): Patients developing postoperative
acute kidney injury after cardiac surgery were compared with patients who
did not develop acute kidney injury. <br/>Measurements and Main Results:
The search identified 4,329 unique studies, 87 underwent full-text review,
and 12 were included for analysis. Mean acute kidney injury occurrence
across studies was 16% (minimum-maximum: 8-50), while mean occurrence of
CKD was 24% (minimum-maximum: 3-35), with high variability depending on
definitions and follow-up time. Acute kidney injury was associated with
increased odds of CKD in all individual studies. The pooled odds ratio
across studies was 5.67 (95% confidence interval, 3.34-9.64; p < 0.0001).
<br/>Conclusion(s): Acute kidney injury after cardiac surgery was
associated with a more than 5-fold increased odds of developing CKD.
New-onset CKD occurred in almost 1 in 4 patients in the years after
surgery.<br/>Copyright &#xa9; 2024 The Authors

<50>
Accession Number
2032741863
Title
A review regarding the article 'Traditional Chinese medicine compound
(Tongxinluo) and clinical outcomes of patients with acute myocardial
infarction the CTS-AMI randomized clinical trial'.
Source
Current Problems in Cardiology. 49(9) (no pagination), 2024. Article
Number: 102692. Date of Publication: September 2024.
Author
Zhu H.; Jia G.
Institution
(Zhu, Jia) Department of Oncology, The 2nd Affiliated Hospital of Chengdu
Medical College & Nuclear Industry 416 Hospital, Chengdu 102413, China
Publisher
Elsevier Inc.
Abstract
Tongxinluo, a traditional Chinese medicine compound, has shown promise in
improving outcomes for patients with ST-segment elevation myocardial
infarction (STEMI). This randomized, double-blind, placebo-controlled
trial investigated the efficacy of Tongxinluo in reducing major adverse
cardiac and cerebrovascular events (MACCEs) in STEMI patients. The study
enrolled 3777 patients from 124 hospitals in China, all of whom received
standard STEMI treatments in addition to either Tongxinluo or placebo for
12 months. The primary endpoint was the occurrence of MACCEs at 30 days,
with secondary endpoints including individual components of MACCEs, severe
STEMI complications, major bleeding, and all-cause mortality at 1 yr.
Results showed that Tongxinluo significantly reduced the 30-day MACCE rate
compared to placebo (3.4 % vs 5.2 %), and this benefit persisted at 1 year
(5.3 % vs 8.3 %). Cardiac death and myocardial reinfarction rates were
also significantly lower in the Tongxinluo group. These findings
underscore the importance of integrating traditional Chinese medicine with
conventional Western medical treatments, providing significant evidence to
support the development of evidence-based practices in traditional Chinese
medicine. This study represents a pivotal advancement in the field of TCM,
demonstrating its potential to contribute meaningfully to modern clinical
practice and highlighting the necessity for further high-quality research
in this area.<br/>Copyright &#xa9; 2024 The Author(s)

<51>
Accession Number
2032729112
Title
Effect of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on
N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and structural
changes following myocardial infarction: A systematic review and
meta-analysis.
Source
International Journal of Cardiology. 410 (no pagination), 2024. Article
Number: 132239. Date of Publication: 01 Sep 2024.
Author
Banjar S.; Alharbi S.; Omer I.; Al Zaid N.; Alghamdi A.; Abuthiyab N.;
Alzahrani A.
Institution
(Banjar, Alharbi, Omer, Al Zaid, Alghamdi, Abuthiyab, Alzahrani) College
of Medicine, King Saud bin Abdulaziz University for Health Sciences,
Jeddah, Saudi Arabia
(Banjar, Alharbi, Omer, Al Zaid, Alghamdi, Abuthiyab, Alzahrani) King
Abdullah International Medical Research Center, Jeddah, Saudi Arabia
(Alzahrani) Department of Cardiac Sciences, Ministry of the National
Guard- Health Affairs, Jeddah, Saudi Arabia
Publisher
Elsevier Ireland Ltd
Abstract
Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are
anti-hyperglycemic drugs and have been proven to have cardiovascular
protective effects for patients with heart failure regardless of their
diabetes status. However, the benefit of SGLT2i following myocardial
infarction (MI) remains incompletely established. This review aimed to
investigate the impact of SGLT2i on NT-proBNP levels and structural
changes post-MI. <br/>Method(s): Medline, ClinicalTrial.gov, Scopus, and
Directory of open-access journals were searched to retrieve the relevant
articles. Eligible studies were randomized clinical trials that assessed
NT-proBNP and cardiac structural changes in patients who received SGLT2i
compared to placebo following MI. Two reviewers independently screened
articles, extracted data, and assessed study quality. <br/>Result(s): Four
studies were included in this review, including patients with and without
diabetes. While two studies showed no marked decrease from the baseline in
NT-proBNP levels between the SGLT2i group and the control group, two
studies reported a substantial reduction. The meta-analysis included three
of these studies, with a total of 238 participants. The meta-analysis did
not find a statistically significant drop in NT-proBNP levels post-MI in
the SGLT2 inhibitors group compared to placebo (pooled SMD = 0.16, 95% CI
0.57-0.26, P 0.45). Furthermore, different echocardiographic parameters
were reported in the included trials, yet no meta-analysis could be
conducted to assess the influence of SGLT2i on cardiac remodeling post-MI.
<br/>Conclusion(s): SGLT2i did not result in a statistically significant
reduction of NT-proBNP level subsequent to myocardial infarction. A
knowledge gap exists regarding the impact of these agents on cardiac
remodeling post-MI. Future high-quality clinical trials are needed to
provide more robust evidence.<br/>Copyright &#xa9; 2024 The Authors

<52>
Accession Number
2032678803
Title
Potential clinical applications of current and future oral forms of
desmopressin (Review).
Source
Experimental and Therapeutic Medicine. 28(2) (no pagination), 2024.
Article Number: 303. Date of Publication: August 2024.
Author
Everaert K.; Holm-Larsen T.; Kheir G.B.; Rottey S.; Weiss J.P.; Vande
Walle J.; Kabarriti A.E.; Dossche L.; Herve F.; Spinoit A.-F.; Norgaard
J.P.; Juul K.V.
Institution
(Everaert, Holm-Larsen) Faculty of Medicine and Health Sciences,
Department of Human Structure and Repair, Ghent University Hospital, Ghent
9000, Belgium
(Kheir, Herve) Department of Urology, Ghent University Hospital, Ghent
9000, Belgium
(Rottey) Drug Research Unit, Department of Medical Oncology, Ghent
University Hospital, Ghent 9000, Belgium
(Weiss, Kabarriti) Department of Urology, State University of New York
Downstate Health Sciences University, New York City, NY 11203, United
States
(Vande Walle) Department of Pediatric Nephrology, Ghent University
Hospital, Ghent 9000, Belgium
(Dossche) Faculty of Medicine and Health Sciences, Department of Internal
Medicine and Pediatrics, Ghent University Hospital, Ghent 9000, Belgium
(Spinoit) Department of Pediatric and Reconstructive Urology, Ghent
University Hospital, Ghent 9000, Belgium
(Norgaard, Juul) Research and Development, Ferring Pharmaceuticals A/S,
Ferring International PharmaScience Center, Copenhagen 2770, Denmark
Publisher
Spandidos Publications
Abstract
Desmopressin is a synthetic analogue of vasopressin and a selective
vasopressin receptor 2 agonist. It was first synthesised in 1967 and
utilised for its antidiuretic properties. It is also used in bleeding
disorders to enhance clotting. Other potential uses of the drug have been
reported. The present review aims to provide a broad overview of the
literature on potential further uses of oral forms of desmopressin. Key
therapeutic areas of interest were identified based on known physiological
activities/targets of desmopressin or reports of an effect of desmopressin
in the literature. The feasibility of adequate dosing with oral forms of
the drug was also considered. Systematic literature searches were carried
out using the silvi.ai software for the identified areas, and summaries of
available papers were included in tables and discussed. The results of the
searches showed that desmopressin has been investigated for its efficacy
in a number of areas, including bleeding control, renal colic, the central
nervous system and oncology. Evidence suggests that oral desmopressin may
have the potential to be of clinical benefit for renal colic and bleeding
control in particular. However, further research is needed to clarify its
effect in these areas, including randomised controlled studies and studies
specifically of oral formulations (and doses). Further research may also
yield findings for cancer, cognition and overactive bladder.<br/>Copyright
&#xa9; 2024 Everaert et al.

<53>
Accession Number
2032637486
Title
Opioid-free anaesthesia with dexmedetomidine and lidocaine versus
remifentanil-based anaesthesia in cardiac surgery: study protocol of a
French randomised, multicentre and single-blinded OFACS trial.
Source
BMJ Open. 14(6) (no pagination), 2024. Article Number: e079984. Date of
Publication: 03 Jun 2024.
Author
Besnier E.; Moussa M.D.; Thill C.; Vallin F.; Donnadieu N.; Ruault S.;
Lorne E.; Scherrer V.; Lanoiselee J.; Lefebvre T.; Sentenac P.; Abou-Arab
O.
Institution
(Besnier, Scherrer) Department of Anesthesia and Critical Care, Rouen
University Hospital, Rouen, France
(Besnier) U1096, Inserm, Rouen, France
(Moussa, Lanoiselee) Department of Anesthesiology and Critical Care, Lille
University Hospital, Lille, France
(Moussa) Ulr 2694-METRICS: Evaluation des Technologies de Sante et des
Pratiques Medicales, Univ.Lille, Lille, France
(Thill) Department of Biostatistics, Rouen University Hospital, Rouen,
France
(Vallin, Ruault) Research Department, Rouen University Hospital, Rouen,
France
(Donnadieu) Department of Pharmacy, Rouen University Hospital, Rouen,
France
(Lorne, Sentenac) Anesthesia and Critical Care Medicine, Clinique du
Millenaire, Montpellier, France
(Lefebvre, Abou-Arab) Department of Anesthesiology and Critical Care,
University Hospital Centre Amiens-Picardie, Amiens, France
Publisher
BMJ Publishing Group
Abstract
Introduction Intraoperative opioids have been used for decades to reduce
negative responses to nociception. However, opioids may have several, and
sometimes serious, adverse effects. Cardiac surgery exposes patients to a
high risk of postoperative complications, some of which are common to
those caused by opioids: acute respiratory failure, postoperative
cognitive dysfunction, postoperative ileus (POI) or death. An opioid-free
anaesthesia (OFA) strategy, based on the use of dexmedetomidine and
lidocaine, may limit these adverse effects, but no randomised trials on
this issue have been published in cardiac surgery. We hypothesised that
OFA versus opioid-based anaesthesia (OBA) may reduce the incidence of
major opioid-related complications after cardiac surgery. Methods and
analysis Multicentre, randomised, parallel and single-blinded clinical
trial in four cardiac surgical centres in France, including 268 patients
scheduled for coronary artery bypass grafting under cardiac bypass, with
or without aortic valve replacement. Patients will be randomised to either
a control OBA protocol using remifentanil or an OFA protocol using
dexmedetomidine/lidocaine. The primary composite endpoint is the
occurrence of at least one of the following: (1) postoperative cognitive
disorder evaluated by the Confusion Assessment Method for the Intensive
Care Unit test, (2) POI, (3) acute respiratory distress or (4) death
within the first 48 postoperative hours. Secondary endpoints are
postoperative pain, morphine consumption, nausea-vomiting, shock, acute
kidney injury, atrioventricular block, pneumonia and length of hospital
stay. Ethics and dissemination This trial has been approved by an
independent ethics committee (Comite de Protection des Personnes Ouest
III-Angers on 23 February 2021). Results will be submitted in
international journals for peer reviewing. Trial registration number
NCT04940689, EudraCT 2020-002126-90.<br/>Copyright &#xa9; 2007 BMJ
Publishing Group Ltd.

<54>
Accession Number
2032147090
Title
A Phase II randomized controlled trial evaluated antithrombotic treatment
with fesomersen in patients with kidney failure on hemodialysis.
Source
Kidney International. 106(1) (pp 145-153), 2024. Date of Publication: July
2024.
Author
Winkelmayer W.C.; Lensing A.W.A.; Thadhani R.I.; Mahaffey K.W.; Walsh M.;
Pap A.F.; Willmann S.; Thelen K.; Hodge S.; Solms A.; Ingham S.J.M.;
Eikelboom J.
Institution
(Winkelmayer) Section of Nephrology, Baylor College of Medicine, Houston,
TX, United States
(Lensing) Clinical Development, Bayer AG, Wuppertal, Germany
(Thadhani) Woodruff Health Sciences Center, Emory School of Medicine,
Atlanta, GA, United States
(Mahaffey) Stanford Center for Clinical Research, Department of Medicine,
Stanford University School of Medicine, Stanford, CA, United States
(Walsh, Eikelboom) Population Health Research Institute, Hamilton Health
Sciences, Hamilton, ON, Canada
(Walsh) McMaster University, Hamilton, ON, Canada
(Walsh) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Walsh) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Pap, Hodge) Clinical Statistics, Bayer AG, Wuppertal, Germany
(Willmann, Solms) Research and Development, Pharmaceuticals, Bayer AG,
Wuppertal/Berlin, Germany
(Thelen) Clinical Pharmacology, Bayer AG, Wuppertal, Germany
(Ingham) Clinical Development and Operations, Bayer SA, Sao Paulo, Brazil
(Ingham) Thrombosis and Atherosclerosis Research Institute, McMaster
University, Hamilton, ON, Canada
(Eikelboom) Hamilton General Hospital, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Patients with kidney failure on hemodialysis (KF-HD) are at high risk for
both atherothrombotic events and bleeding. This Phase IIb study evaluated
the dose-response of fesomersen, an inhibitor of hepatic Factor XI
expression, versus placebo, for bleeding and atherothrombosis in patients
with KF-HD. Patients were randomized to receive fesomersen 40, 80, or 120
mg once-monthly, or matching placebo, for up to 12 months. The primary
safety endpoint was a composite of major bleeding and clinically relevant
non-major bleeding (MB/CRNMB). Exploratory endpoints included
post-dialysis arterio-venous (AV)-access bleeding, major atherothrombotic
events (composite of fatal or non-fatal myocardial infarction, ischemic
stroke, acute limb ischemia/major amputation, systemic embolism,
symptomatic venous thromboembolism), AV-access thrombosis, and clotting of
the hemodialysis circuit. Of 308 participants randomized, 307 received
study treatment and were analyzed. Fesomersen led to a dose-dependent and
sustained reduction of steady-state median FXI levels by 53.6% (40 mg
group), 71.3% (80 mg group), 86.0% (120 mg group), versus 1.9% in the
placebo group. MB/CRNMB events occurred in 6.5% (40 mg group), 5.1% (80 mg
group), 3.9% (120 mg group), and in 4.0% of those receiving placebo
(pooled fesomersen versus placebo P = 0.78). Major atherothrombotic events
occurred in 1 patient (1.3%) in each treatment arm. MB/CRNMB bleeding and
post-dialysis AV-access bleeding were not related to predicted FXI levels.
Lower predicted FXI levels were associated with reductions in hemodialysis
circuit clotting (P = 0.002) and AV-access thrombosis (P = 0.014). In
patients with KF-HD, fesomersen produced a dose-dependent reduction in FXI
levels associated with similar rates of major bleeding compared with
placebo. Registration: URL: https://www.clinicaltrials.gov; unique
identifier: NCT04534114<br/>Copyright &#xa9; 2024 International Society of
Nephrology

<55>
Accession Number
2030109568
Title
The association of triglyceride-glucose index with major adverse
cardiovascular and cerebrovascular events after acute myocardial
infarction: a meta-analysis of cohort studies.
Source
Nutrition and Diabetes. 14(1) (no pagination), 2024. Article Number: 39.
Date of Publication: December 2024.
Author
Liu H.; Wang L.; Wang H.; Hao X.; Du Z.; Li C.; Hou X.
Institution
(Liu, Wang, Wang, Hao, Du, Li, Hou) Centre for Cardiac Intensive Care,
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
Springer Nature
Abstract
Background: Insulin resistance (IR) is indicated to be linked with adverse
outcomes of acute myocardial infarction (AMI), for its pro-inflammatory
and pro-thromboplastic function. The triglyceride-glucose (TyG) index is a
newly developed substitute marker for IR. The aim of this pooled analysis
was to provide a summary of the relationship of TyG index with occurrences
of major adverse cardiovascular and cerebrovascular events (MACCEs) among
populations suffering from AMI. <br/>Method(s): Cohorts reporting
multivariate-adjusted hazard ratios of TyG index with MACCEs or its
independent events were identified through systematically searching
PubMed, MEDLINE, Web of science, Embase and Cochrane databases. Results
were combined using a random-effects model. <br/>Result(s): 21 cohorts
comprising 20403 individuals were included. Compared to individuals in the
lowest TyG category, patients in the highest TyG category exhibited
elevated risks of both MACCEs (P < 0.00001) and all-cause death (P <
0.00001). These findings were in line with the results as TyG analyzed as
continuous variables (MACCEs: P = 0.006; all-cause death: P < 0.00001).
Subgroup analysis demonstrated that diabetic status, type of AMI, nor the
reperfusion therapy did not destruct this correlation (for subgroups, all
P < 0.05). <br/>Conclusion(s): All these indicated that higher TyG index
could potentially predict MACCEs and all-cause death in patients with AMI
as an independent indicator.<br/>Copyright &#xa9; The Author(s) 2024.

<56>
Accession Number
2029700167
Title
Individual dipeptidyl peptidase-4 inhibitors and acute kidney injury in
patients with type 2 diabetes: A systematic review and network
meta-analysis.
Source
Basic and Clinical Pharmacology and Toxicology. 135(1) (pp 71-80), 2024.
Date of Publication: July 2024.
Author
Mitsuboshi S.; Morizumi M.; Kotake K.; Kaseda R.; Narita I.
Institution
(Mitsuboshi) Department of Pharmacy, Kaetsu Hospital, Niigata, Japan
(Morizumi) Department of Pharmacy, Ohno Memorial Hospital, Osaka, Japan
(Kotake) Department of Pharmacy, Okayama Saiseikai General Hospital,
Okayama, Japan
(Kaseda, Narita) Division of Clinical Nephrology and Rheumatology, Niigata
University Graduate School of Medical and Dental Sciences, Niigata, Japan
Publisher
John Wiley and Sons Inc
Abstract
This network meta-analysis of randomized controlled trials aimed to
determine whether any individual dipeptidyl peptidase-4 (DPP-4) inhibitors
increase the risk of acute kidney injury (AKI). The Medical Literature
Analysis and Retrieval System Online via PubMed, the Cochrane Central
Register of Controlled Trials and ClinicalTrials.gov were systematically
searched to identify relevant studies. The primary outcome was AKI. A
frequentist network meta-analysis was performed using a random-effects
model to account for heterogeneity. Twenty-nine studies involving 56 117
participants were included. There were 918 cases of AKI (1.63%). The risk
of bias was generally considered to be low. The only DPP-4 inhibitor that
significantly increased the frequency of AKI when compared with placebo
was sitagliptin (risk ratio 1.65, 95% confidence interval 1.22-2.23).
However, because one study showed significant outliers in the funnel plot,
in a highly heterogeneous population composed solely of patients
undergoing surgery for coronary artery bypass graft, we conducted a
post-hoc sensitivity analysis to exclude this study. The results showed no
statistically significant difference in the risk of AKI between
sitagliptin and placebo. Individual DPP-4 inhibitors do not appear to
increase the risk of AKI. However, sitagliptin may be associated with AKI
in patients with underlying severe cardiovascular disease.<br/>Copyright
&#xa9; 2024 Nordic Association for the Publication of BCPT (former Nordic
Pharmacological Society). Published by John Wiley & Sons Ltd.

<57>
Accession Number
2028606532
Title
Ultrasound-guided versus conventional lung recruitment manoeuvres in
thoracic surgery: a randomised controlled study.
Source
Journal of Clinical Monitoring and Computing. 38(3) (pp 731-739), 2024.
Date of Publication: June 2024.
Author
Wu L.; Yang L.; Yang Y.; Wu X.; Zhang J.
Institution
(Wu, Yang, Yang, Wu, Zhang) Department of Anesthesiology, Fudan University
Shanghai Cancer Center, No. 270, Dong'An Road, Xuhui District, Shanghai
200032, China
(Zhang) Department of Oncology, Shanghai Medical College, Fudan
University, No. 270, Dong'An Road, Xuhui District, Shanghai 200032, China
Publisher
Springer Science and Business Media B.V.
Abstract
Lung recruitment manoeuvres (RMs) during mechanical ventilation may reduce
atelectasis, however, the optimal recruitment strategy for patients
undergoing thoracic surgery remains unknown. Our study was designed to
investigate whether ultrasound-guided lung RMs is superior to conventional
RMs in reducing perioperative atelectasis during thoracic surgery with
one-lung ventilation. We conducted a randomised controlled clinical trial
from August 2022 to September 2022. Sixty patients scheduled for
video-assisted thoracoscopic surgery (VATS) under general anaesthesia were
enrolled. Subjects were randomly divided into the ultrasound-guided RMs
group (manual inflation guided by lung ultrasound) or conventional RMs
group (manual inflation with 30 cmH<inf>2</inf>O pressure). Lung
ultrasound were performed at three predefined time points (1 min after
anaesthetic induction; after RMs at the end of surgery; before discharge
from postanesthesia care unit [PACU]). The primary outcome was lung
ultrasound score before discharge from the PACU after extubation. In the
early postoperative period, lung aeration deteriorated in both groups even
after lung RMs. However, ultrasound-guided lung RMs had significantly
lower lung ultrasound scores when compared with conventional RMs in
bilateral lungs (2.0 [0.8-4.0] vs. 8.0 [3.8-10.3], P < 0.01) at the end of
surgery, which remained before patients discharged from the PACU.
Accordingly, the lower incidence of atelectasis was found in
ultrasound-guided RMs group than in conventional RMs group (7% vs. 53%; P
< 0.01) at the end of surgery. Ultrasound-guided RMs is superior to
conventional RMs in improving lung aeration and reducing the incidence of
lung atelectasis at early postoperative period in patients undergoing
VATS. The study protocol was approved by the Institutional Review Board of
the Fudan University Shanghai Cancer Center (No. 220,825,810; date of
approval: August 5, 2022) and registered on Chinese Clinical Trial
Registry (registration number: ChiCTR2200062761).<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Nature B.V. 2024.

<58>
Accession Number
2027669852
Title
Safety of oral anticoagulants in patients undergoing left ventricular
arrhythmia ablation.
Source
Journal of Interventional Cardiac Electrophysiology. 67(4) (pp 847-849),
2024. Date of Publication: June 2024.
Author
Kewcharoen J.; Shah K.; Mandapati R.; Bhardwaj R.; Turagam M.; Contractor
T.; Lakkireddy D.; Garg J.
Institution
(Kewcharoen, Mandapati, Bhardwaj, Contractor, Garg) Division of
Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health,
11234 Anderson St., Loma Linda, CA 92354, United States
(Shah) Cardiac Arrhythmia Service, MercyOne Siouxland Heart and Vascular
Center, Sioux City, IA, United States
(Turagam) Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Kansas City, KS, United States
Publisher
Springer

<59>
Accession Number
2026751032
Title
Serratus plane block versus standard of care for pain control after
totally endoscopic aortic valve replacement: A double-blind, randomized
controlled, superiority trial.
Source
Regional Anesthesia and Pain Medicine. 49(6) (pp 429-435), 2024. Date of
Publication: 01 Jun 2024.
Author
Vandenbrande J.; Jamaer B.; Stessel B.; Van Hilst E.; Callebaut I.; Yilmaz
A.; Packle L.; Sermeus L.; Blanco R.; Jalil H.
Institution
(Vandenbrande, Jamaer, Stessel, Van Hilst, Callebaut, Jalil) Department of
Anaesthesiology and Pain Medicine, Jessa Hospital Campus Virga Jesse,
Hasselt, Belgium
(Vandenbrande, Stessel, Van Hilst, Callebaut) Faculty of Medicine and Life
Sciences, UHasselt, Hasselt, Belgium
(Jamaer) Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Yilmaz, Packle) Department of Cardiothoracic Surgery, Jessa Hospital
Campus Virga Jesse, Hasselt, Belgium
(Sermeus) Anesthesiology, University Hospital Saint-Luc, Brussels, Belgium
(Blanco) Anaesthesia and Intensive Care, King's College Hospital Dubai,
Abu Dhabi, United Arab Emirates
Publisher
BMJ Publishing Group
Abstract
Introduction Serratus anterior plane block has been proposed to reduce
opioid requirements after minimally invasive cardiac surgery, but
high-quality evidence is lacking. Methods This prospective,
double-blinded, randomized controlled trial recruited patients undergoing
totally endoscopic aortic valve replacement. Patients in the intervention
arm received a single-injection serratus anterior plane block on arrival
to the intensive care unit added to standard of care. Patients in the
control group received routine standard of care, including
patient-controlled intravenous analgesia. Primary outcome was piritramide
consumption within the first 24 hours after serratus anterior plane block
placement. We hypothesized that compared with no block, patients in the
intervention arm would consume 25% less opioids. Results Seventy-five
patients were analyzed (n=38 in intervention arm, n=37 in control arm).
When comparing the serratus anterior plane group with the control group,
median 24-hour cumulative opioid use was 9 (IQR 6-19.5) vs 15 (IQR
11.3-23.3) morphine milligram equivalents, respectively (p<0.01). Also,
pain scores at 4, 8 and 24 hours were lower in the intervention arm at 4,
8 and 24 hours, respectively. Conclusion Combined deep and superficial
single-injection serratus anterior plane block is superior to standard of
care in reducing opioid requirements and postoperative pain intensity up
to 24 hours after totally endoscopic aortic valve
replacement.<br/>Copyright &#xa9; American Society of Regional Anesthesia
& Pain Medicine 2024. Re-use permitted under CC BY-NC. No commercial
re-use. Published by BMJ.

<60>
Accession Number
2032147215
Title
Landiolol for perioperative atrial tachyarrhythmias in cardiac and
thoracic surgery patients: a systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 133(1) (pp 222-225), 2024. Date of
Publication: July 2024.
Author
Kowalik K.; Silverman M.; Oraii A.; Conen D.; Belley-Cote E.P.; Healey
J.S.; Um K.J.; Inami T.; Wanner P.M.; Wang M.K.; Pandey A.; Udayashankar
A.; Whitlock R.P.; Devereaux P.J.; McIntyre W.F.
Institution
(Kowalik, Silverman, Pandey, Udayashankar) Michael G. DeGroote School of
Medicine, Hamilton, ON, Canada
(Oraii, Conen, Belley-Cote, Healey, Wanner, Wang, Whitlock, Devereaux,
McIntyre) Population Health Research Institute, Hamilton, ON, Canada
(Um) McMaster University, Hamilton, ON, Canada
(Inami) Nippon Medical School, Tokyo, Japan
Publisher
Elsevier Ltd

<61>
[Use Link to view the full text]
Accession Number
631584423
Title
Postoperative Pain and Analgesic Requirements in the First Year after
Intraoperative Methadone for Complex Spine and Cardiac Surgery.
Source
Anesthesiology. 132(2) (pp 330-342), 2020. Date of Publication: 01 Feb
2020.
Author
Murphy G.S.; Avram M.J.; Greenberg S.B.; Shear T.D.; Deshur M.A.;
Dickerson D.; Bilimoria S.; Benson J.; Maher C.E.; Trenk G.J.; Teister
K.J.; Szokol J.W.
Institution
(Murphy, Greenberg, Shear, Deshur, Dickerson, Bilimoria, Benson, Maher,
Trenk, Teister, Szokol) Department of Anesthesiology, NorthShore
University HealthSystem, University of Chicago Pritzker School of
Medicine, Evanston, IL, United States
(Avram) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Methadone is a long-acting opioid that has been reported to
reduce postoperative pain scores and analgesic requirements and may
attenuate development of chronic postsurgical pain. The aim of this
secondary analysis of two previous trials was to follow up with patients
who had received a single intraoperative dose of either methadone or
traditional opioids for complex spine or cardiac surgical procedures.
<br/>Method(s): Preplanned analyses of long-term outcomes were conducted
for spinal surgery patients randomized to receive 0.2 mg/kg methadone at
the start of surgery or 2 mg hydromorphone at surgical closure, and for
cardiac surgery patients randomized to receive 0.3 mg/kg methadone or 12
mug/kg fentanyl intraoperatively. A pain questionnaire assessing the
weekly frequency (the primary outcome) and intensity of pain was mailed to
subjects 1, 3, 6, and 12 months after surgery. Ordinal data were compared
with the Mann-Whitney U test, and nominal data were compared using the
chi-square test or Fisher exact probability test. The criterion for
rejection of the null hypothesis was P < 0.01. <br/>Result(s): Three
months after surgery, patients randomized to receive methadone for spine
procedures reported the weekly frequency of chronic pain was less (median
score 0 on a 0 to 4 scale [less than once a week] vs. 3 [daily] in the
hydromorphone group, P = 0.004). Patients randomized to receive methadone
for cardiac surgery reported the frequency of postsurgical pain was less
at 1 month (median score 0) than it was in patients randomized to receive
fentanyl (median score 2 [twice per week], P = 0.004). <br/>Conclusion(s):
Analgesic benefits of a single dose of intraoperative methadone were
observed during the first 3 months after spinal surgery (but not at 6 and
12 months), and during the first month after cardiac surgery, when the
intensity and frequency of pain were the greatest.<br/>Copyright &#xa9;
2020, the American Society of Anesthesiologists, Inc.

<62>
Accession Number
644483251
Title
Acute Risk Factors Associated With Health Service Use Within 90 Days
Before Stroke: A Systematic Review and Meta-Analysis.
Source
Stroke. Conference: American Stroke Association's 2024 International
Stroke Conference, State-of-the-Science Stroke Nursing Symposium 2024, and
HEADS-UP: Health Equity and Actionable Disparities in Stroke:
Understanding and Problem-solving Pre-Conference Symposium 2024. Phoenix,
AZ United States. 55(Supplement 1) (no pagination), 2024. Date of
Publication: February 2024.
Author
Kalpakavadi S.; Sun A.; Kodithuwakku V.; Rehman S.; Gall S.
Publisher
Wolters Kluwer Health
Abstract
Background: While traditional risk factors are chronic in nature, it is
difficult to predict the risk of stroke with respect to time. Identifying
certain acute risk factors, particularly associated with a health service
contact, may help to prevent stroke. We performed a systematic review to
understand the acute risk factors having health service contact within 90
days before incident strokes. <br/>Method(s): PubMed, Embase and Scopus
were searched for studies within last 10 years (2013- September 2022).
Studies selected using PRISMA guidelines underwent quality assessment with
Newcastle Ottawa scale. Three reviewers independently reviewed and
included case control, casecrossover, self-controlled case series and
cohort studies that reported raw data or estimates of association between
acute events having healthcare contact within 90 days and stroke.
<br/>Result(s): 106 studies across 14 countries were included from 12,628
records. Most studies reported all types of strokes as the outcome, with
the most evaluated risk-periods being 30 and 90 days before stroke. Groups
of acute risk factors were identified based on the reason for healthcare
contact. Surgeries(n=43) and medical conditions(n=37) were the commonest
groups identified for contacting health services in the acute period
before stroke, followed by medications(n=14) and other reasons(n=12)
including vaccinations and pathology tests. Subgroups were identified
based on the type of acute risk factor (Figure 1). The most commonly
examined acute risk factors included infections, myocardial infarction,
cardiac surgeries, use of antipsychotics and influenza vaccines. Detailed
meta-analyses summarizing the magnitude of effect under each sub-group
will be presented. <br/>Conclusion(s): Potential acute risk factors having
healthcare contact within 90 days preceding stroke have been identified.
Further research to assess the role of interventions in health services
addressing the risk of stroke from these events is warranted.(Figure
Presented).

<63>
Accession Number
2030190521
Title
Loco-Regional Anesthesia for Pain Management in Robotic Thoracic Surgery.
Source
Journal of Clinical Medicine. 13(11) (no pagination), 2024. Article
Number: 3141. Date of Publication: June 2024.
Author
La Via L.; Cavaleri M.; Terminella A.; Sorbello M.; Cusumano G.
Institution
(La Via, Cavaleri) Department of Anesthesia and Intensive Care, Azienda
Ospedaliera Universitaria Policlinico "G. Rodolico-San Marco", Catania
95123, Italy
(Terminella, Cusumano) Department of Thoracic Surgery, Azienda Ospedaliera
Universitaria Policlinico "G. Rodolico-San Marco", Catania 95123, Italy
(Sorbello) Faculty of Medicine and Surgery, University "Kore", Enna 94100,
Italy
(Cusumano) Department of General Surgery and Medical-Surgical Specialties,
University of Catania, Catania 95123, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Robotic thoracic surgery is a prominent minimally invasive approach for
the treatment of various thoracic diseases. While this technique offers
numerous benefits including reduced blood loss, shorter hospital stays,
and less postoperative pain, effective pain management remains crucial to
enhance recovery and minimize complications. This review focuses on the
application of various loco-regional anesthesia techniques in robotic
thoracic surgery, particularly emphasizing their role in pain management.
Techniques such as local infiltration anesthesia (LIA), thoracic epidural
anesthesia (TEA), paravertebral block (PVB), intercostal nerve block
(INB), and erector spinae plane block (ESPB) are explored in detail
regarding their methodologies, benefits, and potential limitations. The
review also discusses the imperative of integrating these anesthesia
methods with robotic surgery to optimize patient outcomes. The findings
suggest that while each technique has unique advantages, the choice of
anesthesia should be tailored to the patient's clinical status, the
complexity of the surgery, and the specific requirements of robotic
thoracic procedures. The review concludes that a multimodal analgesia
strategy, potentially incorporating several of these techniques, may offer
the most effective approach for managing perioperative pain in robotic
thoracic surgery. Future directions include refining these techniques
through technological advancements like ultrasound guidance and exploring
the long-term impacts of loco-regional anesthesia on patient recovery and
surgical outcomes in the context of robotic thoracic
surgery.<br/>Copyright &#xa9; 2024 by the authors.

<64>
Accession Number
2030190498
Title
Carotid Interventions in Patients Undergoing Coronary Artery Bypass
Grafting: A Narrative Review.
Source
Journal of Clinical Medicine. 13(11) (no pagination), 2024. Article
Number: 3019. Date of Publication: June 2024.
Author
Xodo A.; Gregio A.; Pilon F.; Milite D.; Danesi T.H.; Badalamenti G.;
Lepidi S.; D'Oria M.
Institution
(Xodo, Gregio, Pilon, Milite) Vascular and Endovascular Surgery Division,
"San Bortolo" Hospital, AULSS8 Berica, Vicenza 36100, Italy
(Danesi) Division of Cardiac Surgery, Brigham and Women's Hospital,
Boston, MA 02115, United States
(Badalamenti, Lepidi, D'Oria) Vascular and Endovascular Surgery,
Department of Clinical Surgical and Health Sciences, University of
Trieste, Trieste 34149, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Simultaneous carotid artery stenosis (CS) and coronary artery disease
(CAD) is a common condition among patients with several cardiovascular
risk factors; however, its optimal management still remains under
investigation, such as the assumption that carotid disease is causally
related to perioperative stroke and that preventive carotid
revascularization decrease the risk of this complication. Synchronous
surgical approach to both conditions, performing carotid endarterectomy
(CEA) before coronary artery bypass graft (CABG) during the same
procedure, should still be considered in selective patients, in order to
reduce the risk of perioperative stroke during coronary cardiac surgery.
For the same purpose, staged approaches, such as CEA followed by CABG or
CABG followed by CEA during the same hospitalization or a few weeks later
have been described. Hybrid approach with carotid artery stenting (CAS)
and CABG can also be an option in selected cases, offering a minimally
invasive procedure to treat CS among patients whom CABG cannot be
postponed. When carotid intervention is indicated in patients with
concomitant CAD requiring CABG, a personalized and tailored approach is
mandatory, especially in asymptomatic patients, in order to define the
ideal surgical strategy. The aim of this paper is to summarize the current
"state of the art" of the different approaches to carotid artery diseases
in patients undergoing CABG.<br/>Copyright &#xa9; 2024 by the authors.

<65>
Accession Number
2032820479
Title
Zero-contrast left atrial appendage closure, a feasible alternative for
patients with a high risk of contrast-induced nephropathy: Systematic
literature review and meta-analysis.
Source
Heart Rhythm. (no pagination), 2024. Date of Publication: 2024.
Author
Rodriguez J.F.; Pachon-Londono M.J.; Areiza L.A.; Rodriguez W.G.
Institution
(Rodriguez, Pachon-Londono) Universidad del Rosario, Bogota, Colombia
(Areiza) Hospital Universitario Mayor, Mederi, Bogota, Colombia
(Rodriguez) Colsubsidio Calle 63, Bogota, Colombia
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) is an alternative to
reduce thrombotic risk in patients with nonvalvular atrial fibrillation.
This procedure conventionally requires the use of a contrast agent. A
significant proportion of patients who undergo this procedure have chronic
kidney disease, with a high risk of contrast-induced nephropathy.
<br/>Objective(s): We aimed to systematically review existing literature
regarding the feasibility and safety of a zero-contrast LAAC technique.
<br/>Method(s): We searched the MEDLINE/PubMed, Embase, and Cochrane
Central Register of Controlled Trials databases for studies comparing a
zero-contrast LAAC technique with conventional LAAC up to April 2024. From
each study, we extracted baseline characteristics, feasibility, and safety
outcomes. A random model meta-analysis was used to compare outcomes
between groups. <br/>Result(s): Five studies reporting data from 367
patients were included. A 100% successful implantation rate was reported
in all the zero-contrast groups. The mean number of recaptures reached no
significant difference between the groups (mean difference, -0.15; CI,
-0.67 to 0.37; I² = 0%; P = .58). The zero-contrast group had a
significantly shorter fluoroscopy time (mean difference, -4.03; CI, -7.72
to -0.34; I² = 67%; P = .03). Complications related to the
procedure, peridevice leak, and device-associated thrombus rates were not
significantly different between the groups. <br/>Conclusion(s):
Zero-contrast LAAC is a feasible alternative. The success and complication
rates are consistent with those of conventional LAAC. Aside from the
inherent benefit of zero-contrast exposure, this technique allows a
reduction in fluoroscopy time.<br/>Copyright &#xa9; 2024 Heart Rhythm
Society

<66>
Accession Number
2032712301
Title
Electroencephalography-Guided Anesthesia and Delirium in Older Adults
After Cardiac Surgery: The ENGAGES-Canada Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
Deschamps A.; Ben Abdallah A.; Jacobsohn E.; Saha T.; Djaiani G.;
El-Gabalawy R.; Overbeek C.; Palermo J.; Courbe A.; Cloutier I.; Tanzola
R.; Kronzer A.; Fritz B.A.; Schmitt E.M.; Inouye S.K.; Avidan M.S.
Institution
(Deschamps, Overbeek, Palermo, Courbe) Montreal Heart Institute,
Department of Anesthesiology and Pain Medicine, Universite de Montreal,
5000 rue Belanger, Montreal, QC H1T 1C8, Canada
(Ben Abdallah, Kronzer, Fritz, Avidan) Department of Anesthesiology,
Washington University School of Medicine, St Louis, MO, United States
(Jacobsohn) Department of Anesthesiology Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, MB, Canada
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston, ON, Canada
(Djaiani) Department of Anesthesia, University of Toronto, Toronto, ON,
Canada
(El-Gabalawy) Departments of Clinical Health Psychology and
Anesthesiology, University of Manitoba, Winnipeg, MB, Canada
(Cloutier) Montreal Health Innovations Coordinating Center, Montreal Heart
Institute, Montreal, QC, Canada
(Schmitt, Inouye) Department of Medicine, Beth Israel-Deaconess Medical
Center, Marcus Institute for Aging Research, Hebrew Senior Life, Harvard
Medical School, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: Intraoperative electroencephalogram (EEG) waveform
suppression, suggesting excessive general anesthesia, has been associated
with postoperative delirium. <br/>Objective(s): To assess whether
EEG-guided anesthesia decreases the incidence of delirium after cardiac
surgery. <br/>Design, Setting, and Participant(s): Randomized,
parallel-group clinical trial of 1140 adults 60 years or older undergoing
cardiac surgery at 4 Canadian hospitals. Recruitment was from December
2016 to February 2022, with follow-up until February 2023.
<br/>Intervention(s): Patients were randomized in a 1:1 ratio (stratified
by hospital) to receive EEG-guided anesthesia (n = 567) or usual care (n =
573). Patients and those assessing outcomes were blinded to group
assignment. <br/>Main Outcomes and Measures: The primary outcome was
delirium during postoperative days 1 through 5. Intraoperative measures
included anesthetic concentration and EEG suppression time. Secondary
outcomes included intensive care and hospital length of stay. Serious
adverse events included intraoperative awareness, medical complications,
and 30-day mortality. <br/>Result(s): Of 1140 randomized patients (median
[IQR] age, 70 [65-75] years; 282 [24.7%] women), 1131 (99.2%) were
assessed for the primary outcome. Delirium during postoperative days 1 to
5 occurred in 102 of 562 patients (18.15%) in the EEG-guided group and 103
of 569 patients (18.10%) in the usual care group (difference, 0.05% [95%
CI, -4.57% to 4.67%]). In the EEG-guided group compared with the usual
care group, the median volatile anesthetic minimum alveolar concentration
was 0.14 (95% CI, 0.15 to 0.13) lower (0.66 vs 0.80) and there was a
7.7-minute (95% CI, 10.6 to 4.7) decrease in the median total time spent
with EEG suppression (4.0 vs 11.7 min). There were no significant
differences between groups in median length of intensive care unit
(difference, 0 days [95% CI, -0.31 to 0.31]) or hospital stay (difference,
0 days [95% CI, -0.94 to 0.94]). No patients reported intraoperative
awareness. Medical complications occurred in 64 of 567 patients (11.3%) in
the EEG-guided group and 73 of 573 (12.7%) in the usual care group.
Thirty-day mortality occurred in 8 of 567 patients (1.4%) in the
EEG-guided group and 13 of 573 (2.3%) in the usual care group.
<br/>Conclusions and Relevance: Among older adults undergoing cardiac
surgery, EEG-guided anesthetic administration to minimize EEG suppression,
compared with usual care, did not decrease the incidence of postoperative
delirium. This finding does not support EEG-guided anesthesia for this
indication. Trial Registration: ClinicalTrials.gov Identifier:
NCT02692300.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<67>
Accession Number
2032688812
Title
Ultrasound-guided mid point-transverse process to pleura block versus
thoracic paravertebral block in pediatric open-heart surgery: A randomized
controlled non-inferiority study.
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111507. Date of Publication: October 2024.
Author
Abourezk A.R.; Abdelbaser I.; Badran A.; Abdelfattah M.
Institution
(Abourezk, Abdelbaser, Badran, Abdelfattah) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
Publisher
Elsevier Inc.
Abstract
Study objective: The mid point-transverse process to pleura block (MTPB)
is a new variant of thoracic paravertebral block (TPVB). This study aimed
to compare TPVB and MTPB with respect to intraoperative attenuation of the
hemodynamic stress response to surgery and postoperative analgesia in
pediatric open heart surgery with midline sternotomy. <br/>Design(s): A
single-center, randomized, controlled, double-blind, non-inferiority
study. <br/>Setting(s): Tertiary care children's university hospital.
<br/>Patient(s): We recruited 83 children aged 2-12 years of both sexes
with American Society of Anesthesiologists (ASA) physical status class II
who were scheduled for elective open cardiac surgeries with midline
sternotomy for the repair of simple noncyanotic congenital heart defects.
<br/>Intervention(s): Eligible participants were randomized into either
the TPVB or MTPB groups at a ratio of 1:1. In the TPVB group, patients
were bilaterally injected with 0.4 ml/kg of 0.25% bupivacaine in the
paravertebral space at T4 and T5. In the MTPB group, patients were
bilaterally injected with 0.4 ml/kg of 0.25% bupivacaine mid-transverse
process and pleura just posterior to superior costotransverse ligament at
the level of T4 and T5. Measurements: The primary outcome was the
hemodynamic responses to sternotomy incision, including heart rate (HR)
and invasive mean arterial pressure (MAP), recorded before and after the
induction of anesthesia, after skin incision, after sternotomy, 15 min
after cardiopulmonary bypass (CPB), and after the closure of the sternum.
The secondary outcomes were time needed to perform the bilateral block,
intraoperative fentanyl consumption, postoperative fentanyl consumption,
modified objective pain score (MOPS) measured at 1, 2, 6, 12, 18, and 24 h
after extubation, extubation time, intensive care unit (ICU) discharge
time, and the incidence of non-surgical complications (postoperative
pruritus, postoperative vomiting, pneumothorax, hematoma or local
anesthetic toxicity). <br/>Main Result(s): There were no significant
differences in HR and MAP in the TPVB group compared with the MTPB group
at the following time points: baseline, after induction, after skin
incision, after sternotomy, 15 min after CPB, and after sternal closure.
Intergroup comparisons of HR and MAP did not reveal significant
differences between the groups. The median (IQR) time needed to perform
bilateral MTPB (7[6-8] min) was significantly (p < 0.001) shorter than
that of TPVB (12[10-13] min). Intraoperative fentanyl consumption and
fentanyl consumption in the first postoperative 24 h after extubation were
similar in the TPVB and MTPB groups (4[2-4] vs 4[2-4] and 4.66 +/- 0.649
vs 4.88 +/- 1.082 mug/kg), respectively. Extubation time and ICU discharge
time were comparable in the TPVB and MTPB groups (2[1-3] vs 2[1-3] h and
21.2 +/- 2.5 vs 20.8 +/- 2.6 h), respectively. Measurements of MOPS pain
scores at 1, 2, 6, 12, 18, and 24 h after extubation were similar in both
groups. The incidence of nonsurgical complications was similar in both
groups. <br/>Conclusion(s): MTPB is non-inferior to TPVB in attenuating
the intraoperative hemodynamic stress response to noxious surgical stimuli
and in reducing perioperative opioid consumption, extubation time, and ICU
discharge time. Moreover, MTPB is technically easier than TPVB and
requires less time to perform. Clinical trial registration number The
clinical trial registration was prospectively performed at the Pan African
Clinical Trials Registry (PACTR202204901612169, approval date 01/04/2022,
URL
https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=22602).<br/>Copyright
&#xa9; 2024 Elsevier Inc.

<68>
Accession Number
2032720123
Title
Antiplatelet Therapy, Pretreatment, and Primary PCI: Every Minute Counts.
Source
Journal of the American College of Cardiology. 83(25) (pp 2640-2642),
2024. Date of Publication: 25 Jun 2024.
Author
Silvain J.; Montalescot G.; Guedeney P.
Institution
(Silvain, Montalescot, Guedeney) Sorbonne Universite, ACTION Study Group,
INSERM UMRS1166, ICAN-Institut de Cardiologie, Hopital Pitie-Salpetriere
(AP-HP), Paris, France
Publisher
Elsevier Inc.

<69>
Accession Number
2030003151
Title
Robot-Assisted Thoracoscopic Resection of Ectopic Parathyroid Tissue in
Mediastinum: A Scoping Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 19(1) (pp 17-22), 2024. Date of Publication: January/February
2024.
Author
Anemoulis M.; Kachtsidis V.; Geropoulos G.; Panagiotopoulos N.
Institution
(Anemoulis, Kachtsidis, Geropoulos) School of Medicine, Aristotle
University of Thessaloniki, Greece
(Geropoulos) Department of General Surgery, Victoria Hospital, NHS Fife,
Kirkcaldy, United Kingdom
(Panagiotopoulos) Department of Thoracic Surgery, University College
London Hospitals, NHS Foundation Trust, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Ectopic parathyroid tissue in the mediastinum represents a rare and
potentially serious clinical entity with challenging diagnostic and
surgical management. The main surgical approach for this issue is open
thoracotomy, which is a safe technique but carries risks and complications
associated with such as extensive surgery. The purpose of this study is to
demonstrate robotic thoracic surgery as an alternative and potentially
advantageous method to treat patients with ectopic parathyroid adenomas
compared with open and video-assisted thoracoscopic surgery approaches. A
total of 13 reports in the literature were identified that provided
details in terms of complications, surgical approach, and results of
minimally invasive surgical resection of mediastinal ectopic parathyroid
tissue.<br/>Copyright &#xa9; The Author(s) 2024.

<70>
Accession Number
2030153074
Title
Clinical characteristics and outcomes in pseudomonas endocarditis: a
systematic review of individual cases: Systematic review of pseudomonas
endocarditis.
Source
Infection. (no pagination), 2024. Date of Publication: 2024.
Author
Meena D.S.; Kumar D.; Kumar B.; Bohra G.K.; Midha N.; Garg M.K.
Institution
(Meena, Kumar, Kumar, Bohra, Midha, Garg) Division of Infectious Diseases,
Department of Internal Medicine, All India Institute of Medical Sciences,
Jodhpur 342005, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The landscape of Pseudomonas infective endocarditis (IE) is
evolving with the widespread use of cardiac implantable devices and
hospital-acquired infections. This systematic review aimed to evaluate the
emerging risk factors and outcomes in Pseudomonas IE. <br/>Method(s): A
literature search was performed in major electronic databases (PubMed,
Scopus, and Google Scholar) with appropriate keywords and combinations
till November 2023. We recorded data for risk factors, diagnostic and
treatment modalities. This study is registered with PROSPERO,
CRD42023442807. <br/>Result(s): A total of 218 cases (131 articles) were
included. Intravenous drug use (IDUs) and prosthetic valve endocarditis
(PVE) were major risk factors for IE (37.6% and 22%). However, the
prosthetic valve was the predominant risk factor in the last two decades
(23.5%). Paravalvular complications (paravalvular leak, abscess, or
pseudoaneurysm) were described in 40 cases (18%), and the vast majority
belonged to the aortic valve (70%). The mean time from symptom onset to
presentation was 14 days. The incidence of difficult-to-treat resistant
(DTR) pseudomonas was 7.4%. Valve replacement was performed in 57.3% of
cases. Combination antibiotics were used in most cases (77%), with the
aminoglycosides-based combination being the most frequently used (66%).
The overall mortality rate was 26.1%. The recurrence rate was 11.2%.
Almost half of these patients were IDUs (47%), and most had aortic valve
endocarditis (76%). <br/>Conclusion(s): This review highlights the
changing epidemiology of Pseudomonas endocarditis with the emergence of
prosthetic valve infections. Acute presentation and associated high
mortality are characteristic of Pseudomonas IE and require aggressive
diagnostic and therapeutic approach.<br/>Copyright &#xa9; Springer-Verlag
GmbH Germany, part of Springer Nature 2024.

<71>
Accession Number
2032753938
Title
CONTRAST ENHANCED HARMONIC EUS-GUIDED VERSUS CONVENTIONAL EUS-GUIDED FINE
NEEDLE BIOPSY WITH MACROSCOPIC ON-SITE EVALUATION FOR SOLID PANCREATIC
LESIONS: A MULTICENTER RANDOMIZED TRIAL.
Source
Gastrointestinal Endoscopy. Conference: Digestive Disease Week (DDW),
2024. Washington United States. 99(6 Supplement) (pp AB857-AB858), 2024.
Date of Publication: June 2024.
Author
Tang R.; Ligresti D.; Kim T.H.; Tarantino I.; Traina M.; Liotta R.; Ip P.;
Lok H.-T.; Fung A.; Kung J.; Lo E.; Wong M.; Chan T.T.; Lai J.; Wai Leung
H.H.; Sia F.; Yau K.W.; Teoh A.; Yan Chiu P.W.; Chong C.
Publisher
Elsevier Inc.
Abstract
Institutions: The Chinese University of Hong Kong Department of Medicine
and Therapeutics, Hong Kong; The Chinese University of Hong Kong State Key
Laboratory of Digestive Disease, Hong Kong; Endoscopy Service, Department
of Diagnostic and Therapeutic Services, IRCCS - ISMETT, Italy; Department
of Internal Medicine, Wonkwang University School of Medicine, Korea (the
Republic of); Pathology Unit, Department of Diagnostic and Therapeutic
Services, IRCCS - ISMETT, Italy; The Chinese University of Hong Kong
Department of Surgery, Hong Kong; The Chinese University of Hong Kong
Department of Anatomical and Cellular Pathology, Hong Kong; The Chinese
University of Hong Kong Institute of Digestive Disease, Hong Kong.
Disclosure compliance: I understand. Participant disclosure: Raymond Tang:
NO financial relationship with a commercial interest; Dario Ligresti: NO
financial relationship with a commercial interest; Tae Hyeon Kim: NO
financial relationship with a commercial interest; Ilaria Tarantino: NO
financial relationship with a commercial interest; Mario Traina: NO
financial relationship with a commercial interest; Rosa Liotta: NO
financial relationship with a commercial interest; Philip Ip: NO financial
relationship with a commercial interest; Hon-Ting Lok: NO financial
relationship with a commercial interest; Andrew Fung: NO financial
relationship with a commercial interest; Janet Kung: NO financial
relationship with a commercial interest; Eugene Lo: NO financial
relationship with a commercial interest; Marc Wong: NO financial
relationship with a commercial interest; Ting Ting Chan: NO financial
relationship with a commercial interest; Jimmy Lai: Advisory Committee or
Review Panels: Gilead Sciences; Howard Ho Wai Leung: NO financial
relationship with a commercial interest; Felix Sia: NO financial
relationship with a commercial interest; Ka Wing Yau: NO financial
relationship with a commercial interest; Anthony Teoh: Consulting: Boston
Scientific Medical, Cook Medical, Taewoong Medical, MI Tech Medical,
Microtech Medical, CMR Surgical; Philip Wai Yan Chiu: Advisory Committee
or Review Panels: Endovision Co Ltd; Board Membership: Cornerstone
Robotics Co Ltd; Grant/Research Support: Olympus Co Ltd, Boston scientific
co ltd; Charing Chong: NO financial relationship with a commercial
interest. <br/>Background(s): While endoscopic ultrasound (EUS) guided
fine needle biopsy (FNB) is the preferred method of tissue acquisition for
pancreatic solid lesions (PSL), false negative result may occur if FNB is
performed in the avascular (necrotic) area. Contrast enhanced harmonic EUS
(CEH EUS) allows better real-time delineation of lesion vascularity and
may help to avoid avascular (necrotic) area during EUS-FNB. This
multicenter randomized controlled trial aims to compare the diagnostic
performance of CEH EUS-guided vs conventional EUS-guided FNB with
macroscopic on-site evaluation (MOSE) for PSL. <br/>Method(s): From 6/2021
to 8/2023, patients aged 18 to 80 years with PSL >=1cm undergoing
EUS-guided tissue acquisition in 3 referral centers in Hong Kong, Italy
and Korea were randomized to undergo CEH EUS-guided FNB or conventional
EUS-guided FNB. In the CEH EUS group, CEH EUS with SonoVue was used to
identify non-enhancing, avascular (necrotic) area in target lesion and
guide FNB to the viable area of the lesion. MOSE was used in both study
arms to assess specimen adequacy. EUS-FNB was deemed complete if the
obtained macroscopic visible core (MVC) was >=4mm. If MVC was <4mm, FNB
was repeated until a total MVC length >=4mm was obtained. Primary outcome
is the false negative rate of the assigned EUS-FNB technique. Secondary
outcomes are sensitivity, specificity, positive predictive value (PPV),
negative predictive value (NPV), procedural time and procedure-related
complications of the assigned technique. <br/>Result(s): 128 patients were
randomized (64 in CEH EUS group, 64 in conventional EUS group). The
baseline patient and PSL characteristics were similar in both groups,
except the rate of pancreatic adenocarcinoma (59.5% vs 79.7%, p=0.013)
(Table 1). Avascular areas were identified on B mode EUS in 25.0% of PSL
in CEH EUS group and 20.3% in conventional EUS group (p=0.526). There was
a non-statistically significant increase in avascular area detection to
31.3% in CEH EUS group. The number of passes needed to achieve a MCV
length >=4mm (1 vs 1.5, p=0.480) and the mean MCV length (16.8mm vs
20.6mm, p=0.259) were similar in both groups. The false negative rates of
CEH EUS-guided and conventional EUS-guided FNB were low and similar (6.0%
vs 7.9%, p>0.999) (Table 2). The sensitivity (94.0% vs 92.1%, p>0.999),
specificity (100% vs 100%, p>0.999) and diagnostic accuracy (95.3% vs
92.2%, p=0.718) were high and comparable in both groups. The procedure
time was slightly longer in CEH EUS group (28.9min vs 24.4min, p=0.039).
The procedure related adverse event rate was low in both groups (1.6% vs
1.6%, p>0.999). <br/>Conclusion(s): In this study, while CEH EUS could
increase the detection of avascular (necrotic) area, the diagnostic
performance of FNB with MOSE guided by CEH EUS or conventional EUS for PSL
were comparable with low false negative rate and high diagnostic accuracy.
[Formula presented] [Formula presented]<br/>Copyright &#xa9; 2024

<72>
Accession Number
644477077
Title
CLINICAL OUTCOMES OF PERCUTANEOUS LEFT ATRIAL APPENDAGE CLOSURE VERSUS
ORAL ANTICOAGULATION IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (pp A52-A53), 2024.
Date of Publication: June 2024.
Author
Leung A.N.W.; Li C.; Khanna S.; Tan T.C.; Bhat A.
Institution
(Leung, Li, Tan, Bhat) Department of Cardiology, Blacktown Hospital, 18
Blacktown Roada, Sydney, Australia
(Khanna) Department of Cardiology, Blacktown Hospital, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Oral anticoagulation (OAC) has long been the standard of care
for stroke prevention for patients with nonvalvular atrial fibrillation
(AF). Left atrial appendage closure (LAAC) has emerged in recent years as
an alternative for individuals where long-term OAC is contraindicated such
as high bleeding risk. Given the ongoing debate surrounding the efficacy
of percutaneous LAAC, this systematic review aims to compare the clinical
outcomes for LAAC versus OAC in this population. Methods A systematic
literature search of medical databases was performed using PRISMA
principles to identify all relevant studies assessing outcomes of
percutaneous LAAC compared to OAC in adults with non-valvular AF (Jan
2000-Sep 2023; English; PROSPERO registration CRD42023464783) (figure 1).
Data for all variables were extracted and those with low heterogeneity
were then meta-analysed using a random- effects model for odds ratios
(ORs) using the longest follow- up duration available by
intention-to-treat. Primary outcomes assessed included stroke and systemic
embolism, major bleeding, and cardiovascular mortality. Results 284
studies were screened, of which 10 full-text studies fulfilled criteria
for inclusion, with a pooled total of 12873 LAAC patients and 12694
patients receiving OAC. In comparison to OAC, LAAC had significantly
reduced rates of haemorrhagic stroke (OR 0.19, CI 0.08-0.50, p=0.001). In
addition, LAAC was also associated with lower rates of thrombotic and
thromboembolic events (OR 0.84, CI 0.75-0.94, p=0.002) and reduced
cardiovascular mortality (OR 0.56, CI 0.46-0.69, p<0.001) (figure 2).
There were no significant differences in baseline characteristics
including AF subtype or CHA2DS2VASC score between the two groups.
Conclusion These results highlight the efficacy of LAAC as an alternative
to OAC with significantly lower rates of thrombotic and thromboembolic
events, as well as cardiovascular mortality. While this data shows promise
for the efficacy of LAAC, further large-scale randomised controlled trials
are warranted to determine its role in routine clinical practice.

<73>
Accession Number
644477022
Title
British Cardiovascular Society Annual Conference, 'Back to the Patient'.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (no pagination), 2024.
Date of Publication: June 2024.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 288 papers. The topics discussed include: a
systematic review and meta-analysis to determine the biological sex ratio
in monogenic genetic and non-genetic dilated cardiomyopathy; incidence and
predictors of sudden cardiac death in dilated cardiomyopathy with improved
ejection fraction; does biological sex impact upon clinical outcomes
following transcatheter aortic valve implantation (TAVI)?; UK research
priorities in cardiomyopathy: results from the James Lind alliance
priority setting partnership; association of myocardial perfusion and
coronary flow reserve with prognosis in patients with aortic stenosis: a
systematic review and meta-analysis; myocardial remodeling patterns in
severe aortic stenosis with bicuspid and tricuspid valve disease, and
reverse remodeling after aortic valve replacement; MAVACAMTEN therapy in
the management of symptomatic obstructive hypertrophic cardiomyopathy: a
single UK center experience; and progression rate of mitral regurgitation
and incidence rate of adverse cardiovascular events in patients with
mitral valve prolapse: a systematic review and meta-analysis.

<74>
Accession Number
644477006
Title
THE VIEWS AND EXPERIENCES OF ASYMPTOMATIC PATIENTS WITH SEVERE AORTIC
STENOSIS FACING INTERVENTION: A LONGITUDINAL QUALITATIVE SUBSTUDY OF A
RANDOMISED TRIAL.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (pp A88-A89), 2024.
Date of Publication: June 2024.
Author
Singh A.; Peter A.; Aslam S.; McCann G.; Tod A.; Ryan T.
Institution
(Singh, Peter) Department of Cardiovascular Sciences, University of
Leicester, Department of Cardiovascular Sciences, Glenfield Hospital,
Leicester LEC LE3 9QP, United Kingdom
(Aslam, Tod, Ryan) School of Allied Health Professions, Nursing and
Midwifery, Faculty of Health, University of Sheffield, United Kingdom
(McCann) University of Leicester, United Kingdom
(McCann) Dept of Cardiovascular Sciences, University of Leicester, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Current guidelines recommend surgical or transcatheter aortic
valve replacement (AVR) for severe aortic stenosis (AS) once symptoms or
left ventricular dysfunction develop, whilst those with asymptomatic
severe AS remain under active surveillance. The EASY-AS randomised control
trial is testing the hypothesis that early surgery in this asymptomatic
group will be beneficial, with participants being randomised to early AVR
vs watchful waiting. It is unusual to offer treatment as invasive as AVR
prophylactically. This makes the views of participants on the timing of
treatment and factors influencing decision-making valuable in informing
future guidelines and trials. Methods A sample of participants of EASY-AS
trial, next of kin and those who declined to participate in the main
trial, were invited to participate in this longitudinal qualitative
substudy. One-to-one semi-structured interviews were conducted by a
qualitative researcher independent of the main trial, using an online
platform or telephone. All interviews were digitally recorded, transcribed
and identifiable data were removed, before thematic analysis was
performed. Up to three semistructured interviews with EASY-AS participants
were conducted (see table 1 and figure 1). Results Data indicates a
willingness for invasive treatment while remaining asymptomatic. The
reasons varied: many believed the trajectory of illness would mean they
required treatment soon anyway; others thought it best to have surgery
while relatively healthy; others relied on clinicians. Next-of-kin views
were consistent with the participants', although their importance to each
decision varied. Reasons against wanting early intervention whilst
asymptomatic included: . My health is good enough at present . My health
is not good enough to risk surgery . My life situation does not permit
surgery at present . Logistics of appointments and transport Reasons for
early intervention . Protect future health . Have surgery while still
healthy . Future wait lists uncertain . Trust in clinicians Decision
making was complex given the serious nature of illness and intervention.
Participants valued the right information. However, it was difficult given
the uncertain trajectory of illness for all. There was also some
discussion of importance of patient choice, for example, relating to TAVI
and valve type. Conclusion This study confirms the complexity of
decisionmaking and highlights the need for clear and accurate information
for patients ahead of trial participation. Recruitment to the EASY-AS
trial is therefore pivotal in providing accurate data for clinicians and
patients in the future. Patients' attitudes to risk and their individual
life situation is an important factor in decision-making. Decision aids
for patients and clinicians might help.

<75>
Accession Number
644476999
Title
THE IMPACT OF EXERCISE INTERVENTIONS ON PHYSICAL FUNCTIONING AND QUALITY
OF LIFE IN ADULTS WITH LONG-TERM CARDIAC CONDITIONS: A SYSTEMATIC REVIEW
AND META-ANALYSIS.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (pp A88), 2024. Date of
Publication: June 2024.
Author
Sze S.; Waterhouse H.; Singh S.; Squire I.
Institution
(Sze, Waterhouse) Leicester University Hospitals NHS Trust, Glenfield
Hospital, Groby Road, Leicester LCE LE3 9QP, United Kingdom
(Singh, Squire) University of Leicester, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Frailty often co-exist in patients with long-term cardiac
conditions and is associated with function dependence and poor quality of
life (QoL). However, treatment options for such patients are limited.
Exercise interventions have been demonstrated to improve physical
functioning in older people, however, their effect in patients with
frailty and long-term cardiac conditions is not well studied. Aim To
evaluate the effect of exercise-based interventions on physical function
and QoL in frail patients with long-term cardiac conditions. Methods We
performed a systematic review and meta-analysis according to the PRISMA
guideline. We searched Medline, Embase, CENTRAL, PEDro, CINAHL electronic
databases for articles published between 2000 and 2023. Studies were
included if they recruited adults >18 years with long-term cardiac
conditions (including acute coronary syndrome (ACS), valve disease, heart
failure (HF), atrial fibrillation, cardiac surgery) who underwent
exercise-based interventions. The primary outcome was change in physical
function (measured using a validated tool) post intervention. We also
assessed the effect of interventions on QoL. Results Twelve studies (14
articles) were included after screening 2697 records and reviewing 91
full-text articles. A total of 1394 patients was studied (median age of
study populations ranged from 64 to 82 years). There were 5 HF, 3 post
transaortic valve implantation, 3 cardiac surgery and 1 post ACS cohorts.
Exercise based interventions were diverse, including 7 inpatient (5 were
continued after discharge as outpatient programmes) and 5 outpatient
interventions. Majority of interventions delivered moderate intensity
exercise (Borg 12- 14). Duration of exercises was shorter in inpatient
(5-30 minutes) than outpatient (30-95 minutes) interventions. Frequency of
exercise were higher in inpatient (5-7 per week) compared to outpatient (2
per week to 1 per month) interventions. The most common physical function
measure was 6-minute walk distance (6MWD). Meta-analysis of 7 randomised
controlled trials (RCTs) showed statistically significant improvement in
6MWD associated with exercise-based interventions compared to controls
[pooled mean difference (95% CI) = 30.5 (17.7-43.3), p<0.001, I2 = 0].
(Figure 1) Four RCTs measured 6MWD in HF populations were evaluated in a
further meta-analysis. Exercise intervention was associated with a
significant improvement in 6MWD in HF patients [pooled mean difference
(95% CI) = 38.5 (21.86- 55.11), p<0.001, I2= 30%]; the magnitude of
improvement in 6MWD exceeded the minimally clinically significant
improvement of 32 m. Six studies evaluated the effect of physical
activity-based intervention on QoL, all of which reported improvement in
QoL, although the improvement did not reach statistical significance in 2
studies. Conclusion Exercise-based interventions were associated with
significant improvement in 6MWD in patients with frailty and long-term
cardiac conditions. There was also a trend towards improvement in QoL.

<76>
Accession Number
644476995
Title
REMOTE ACUTE ASSESSMENT OF PATIENTS WITH HIGH CARDIOVASCULAR RISK
POST-ACUTE CORONARY SYNDROME (TELE-ACS): A RANDOMIZED CONTROLLED TRIAL.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (pp A287), 2024. Date
of Publication: June 2024.
Author
Alshahrani N.S.; Hartley A.; Howard J.; Hajhosseiny R.; Khawaja S.;
Seligman H.; Akbari T.; Alharbi B.A.; Bassett P.; Al-Lamee R.; Francis D.;
Kaura A.; Kelshiker M.A.; Peters N.S.; Khamis R.
Institution
(Alshahrani, Hartley, Howard, Hajhosseiny, Alharbi, Al-Lamee, Francis,
Kaura, Kelshiker, Peters, Khamis) National Heart and Lung Institute,
Imperial College London, United Kingdom
(Alshahrani, Alharbi) King Khalid University, Abha, Saudi Arabia
(Hartley, Howard, Hajhosseiny, Khawaja, Seligman, Akbari, Al-Lamee,
Francis, Kaura, Kelshiker, Peters, Khamis) Imperial College Healthcare NHS
Trust, London, United Kingdom
(Bassett) Statsconsultancy Ltd.,Amersham, Buckinghamshire, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background Unplanned re-admissions after acute coronary syndrome (ACS)
remain high. Telemedicine programmes can provide remote diagnostic
information to aid clinical decision that could optimize and reduce the
need to access hospital care. Methods TELE-ACS is a randomized controlled
trial comparing a telemedicine-based approach versus standard care in
patients following ACS. Patients were suitable for inclusion with at least
one cardiovascular risk factor and presenting with ACS and were randomized
(1:1) prior to discharge. The primary outcome was the frequency of
hospital readmissions at 6-months. Secondary outcomes included emergency
department (ED) visits, major adverse cardiovascular events and
patient-reported symptoms. The primary analysis was performed according to
intention to treat. The trial was registered on ClinicalTrials.gov
(NCT05015634). Results 337 patients were randomized from January 2022 to
April 2023, with a 3.6% drop-out rate. The mean age was 58.1 years. There
was a reduced rate of readmission over 6- months (hazard ratio [HR] 0.24;
95% confidence interval [CI] 0.13 to 0.44; p < 0.001) and ED attendance
(HR 0.59; 95% CI 0.59; 95% CI 0.40 to 0.89) in the telemedicine arm, and
fewer unplanned coronary revascularizations (3% in telemedicine arm versus
9% in standard therapy arm). The occurrence of chest pain (9% versus 24%),
breathlessness (21% versus 39%) and dizziness (6% versus 18%) at 6-months
was lower in the telemedicine group. Conclusions The TELE-ACS has shown
that a telemedicinebased approach for the management of patients following
ACS was associated with a reduction in hospital readmission, ED visits,
unplanned coronary revascularization and patient reported symptoms.

<77>
Accession Number
644476903
Title
EARLY DIFFERENCES IN THE RIGHT VENTRICULAR SIZE AND FUNCTION AFTER
TRANSCATHETER THERAPIES OF TRICUSPID REGURGITATION; A META-ANALYSIS.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2024. Manchester United Kingdom. 110(Supplement 3) (pp A19-A20), 2024.
Date of Publication: June 2024.
Author
Elkammash A.; Chawla H.; Chandramohan N.; Turner M.S.
Institution
(Elkammash, Chawla) Bristol Heart Institute, Upper Maudlin St., Bristol
GLS BS2 8HW, United Kingdom
(Chandramohan) Bristol Royal Infirmary, Bristol, United Kingdom
(Turner) Bristol Heart Institute, Bristol, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Transcatheter Tricuspid valve replacement (TTVR) and
Edge-to-edge repair (T-TEER) are novel treatment options for the
management of right-sided heart failure in patients with severe and
torrential tricuspid valve regurgitation (TR). The effects of these
treatment modalities on cardiac function are not fully defined. In this
meta-analysis, we aimed to study the impact of the different transcatheter
therapies on the right ventricular (RV) size and function. Methods We ran
a systematic review on three different databases (Pubmed Central, EMBASE
and Google Scholar) following the PRISMA protocol and using various
combinations of the search words (tricuspid, transcatheter, replacement,
repair, edge to edge, TTVR and TEER). We included studies and case series
that were published in English and reported the 30-day outcomes post TTVR
and/or T-TEER. We utilised the RV fractional area change (FAC) percentage
and tricuspid annulus peak systolic excursion (TAPSE) to indicate the RV
function. We used the RV basal diameter as a surrogate for the RV size. We
ran a random model meta-analysis using SPSS 28.0 software and assessed the
studies' heterogeneity using the I2 test. We used the Cohen's d test to
determine the effect size of the included studies. Results Two single-arm
prospective studies and one case series met our inclusion criteria for the
TTVR study (number of patients=82).1-3 The mean of the RV basal diameter
improved by 7.48 mm (95% CI 5.92-9.02 mm, P<0.0001). The effect size of
TTVR on RV basal diameter was large (d=-1.18, 95% CI -2.18 to -0.18,
P=0.02). Nonetheless, there was a significant reduction in the mean TAPSE
of 2.4 mm (95% CI 1.5- 3.3 mm, P<0.0001) and mean FAC of 7.77% (95% CI
5.37- 10.16%, P<0.0001) after TTVR. The meta-analysis showed a medium
effect of TTVR on TAPSE (d=- 0.61, 95% CI -0.92 to -0.3, P<0.05) and a
large effect on FAC (d= -1.21, 95% CI -1.55 to -0.88, P<0.05). (Figure 1)
Two single-arm prospective studies met our inclusion criteria for the
T-TEER study (number of patients= 420) [4,5]. The was a non-significant
reduction in the TAPSE post TTEER of 0.55 mm (95%CI -0.05-1.15 mm,
P=0.07). The effect of T-TEER on TAPSE was non-significant (d=- 0.04, 95%
CI -0.16 to 0.09, P=0.56). (Figure 2). There was no significant
heterogeneity in the TTVR and T-TEER studies. Lurz et al.[5] reported a
significant reduction in the mean RV enddiastolic diameter post T-TEER of
3.5 mm (P<0.0001) with a non-significant decrease in the mean RV FAC of
0.5% (P=0.59). We could not find other studies reporting these variables
to run a meta-analysis. We propose that the worse RV function after TTVR
than T-TEER is caused by the greater preload mismatch in cases that
underwent TTVR. TTVR can significantly reduce TR severity, causing a more
substantial preload mismatch compared to T-TEER [6]. Conclusion Despite
the reduction in RV size by both TTVR and T-TEER, TTVR was associated with
a more significant early reduction in the standard measurements of RV
function than T-TEER at 30 days. Such difference between the two
techniques could be secondary to the characteristics of the procedure or
the characteristics of the studied population. Further prospective
randomised controlled trials are needed better to study both procedures'
impact on the RV function.

<78>
Accession Number
644473757
Title
Comparison of Patient Reported Angina with Provider Assigned Canadian
Cardiovascular Society Angina Class Before and After Revascularization.
Source
Circulation: Cardiovascular Quality and Outcomes. Conference: American
Heart Association's Quality of Care and Outcomes Research 2016 Scientific
Sessions. Phoenix, AZ United States. 9(Supplement 2) (no pagination),
2016. Date of Publication: March 2016.
Author
Nassif M.E.; Cohen D.J.; Arnold S.V.; Qintar M.; Farkouh M.E.; Fuster V.;
Spertus J.A.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The Canadian Cardiovascular Society (CCS) classification
system for angina is a critical determinant of revascularization
appropriateness. A major limitation of CCS is that it rates patients'
symptoms from the perspective of providers, rather than patients
themselves. Accordingly, we sought to evaluate the correlation of
physician-assigned CCS class with patient-reported Seattle Angina
Questionnaire (SAQ), before and after revascularization. <br/>Method(s):
Using data from the FREEDOM trial, which randomized 1900 patients from
over 160 international sites to either PCI or CABG, CCS was reported by
physicians and the SAQ was completed by patients prior to randomization
and 1 year later. SAQ angina frequency (SAQ AF) scores were considered to
correspond to CCS class per the following: SAF AF: 100=CCS 0, 61-99=CCS I,
31-60=CCS II, 0-30=CCS III/IV. Agreement between physician- and
patient-reported angina categories was compared using chi square tests.
<br/>Result(s): Among 1640 patients who had CCS and SAQ data at both
baseline and 1-year, the mean age was 63.1 years, 71% were male, and 83%
had 3-vessel coronary disease. Before revascularization, physicians
correctly reported the burden of angina in 25.5% of patients and
overestimated the burden of angina in 62.1%. Among 1194 patients who
reported monthly or no angina, 229 (19.2%) were classified by their
physicians as having CCS III/IV. In contrast, at follow-up, 71.2% of
patients had their angina correctly estimated by their physicians and only
0.6% among the 1568 patients with monthly/no angina were assigned CCS
III/IV by their physicians. Among the 28.8% misclassified by CCS at 1
year, 20.8% had less angina than reported by physicians and 8.0% had more
(Figure; p=0.01). Findings were similar when the analysis was repeated in
patients who were treated with PCI or CABG. <br/>Conclusion(s): In a large
cohort of patients with stable coronary disease undergoing
revascularization, clinicians often overestimated the amount of angina
patients were having prior to revascularization but were significantly
more accurate at follow-up. Given that importance placed on CCS for
enrollment in clinical trials, or assigning appropriateness of
revascularization in clinical practice, using patient-reported symptom
burden as a more unbiased measure should be considered. (Figure
Presented).